Application of restrictive fluid resuscitation in traumatic hemorrhagic shock
限制性液体复苏在创伤失血性休克急救的应用

摘要

目的 创伤失血性休克急救中应用限制性液体复苏的效果分析。方法 选取本院急诊急救中创伤失血性休克的患者100例施行本次调查，回顾2021年3月---2022年3月之间的患者资料，分析积极液体复苏救治的50例、限制性液体复苏救治的50例，剩余碱(BE)值、血红蛋白(HBG)、血小板计数(PLT)、凝血酶原时间(PT)、部分凝血酶原时间(APTT)的数据差；对比两组开始复苏时间、开始手术时间、总输液量；统计两组诱发急性呼吸窘迫综合征（ARDS）、全身炎症反应综合征(SIRA)、急性肾衰竭(ARF)的占比。结果 限制性液体复苏下，患者的生理指标更趋于正常水准。限制性液体复苏组的开始复苏时间为30.4±5.2min，开始手术时间为35.2±11.6min，总输液量为1453±85ml；少于积极液体复苏组。限制性液体复苏组ARDS4例、SIRA3例、ARF2例，共有9例，占比18%；少于积极液体复苏组。（P<0.05）。结论 创伤失血性休克急救的过程中，施行限制性液体复苏，有效改善患者临床指标，可缩短复苏时间并降低输液量，预防有关的并发症，促使患者休克急救效果提升。

Abstract

Objective: To analyze the effect of restrictive fluid resuscitation in first aid for traumatic hemorrhagic shock.
Methods A total of 100 patients with traumatic hemorrhagic shock in emergency emergency in our hospital were selected for this investigation. The data of patients between March 2021 and March 2022 were reviewed, and 50 patients treated with active fluid resuscitation, restrictive fluid In the 50 cases resuscitated and treated, the data of residual base (BE) value, hemoglobin (HBG), platelet count (PLT), prothrombin time (PT) and partial prothrombin time (APTT) were poor; the start of resuscitation time between the two groups was compared. , operation time, total infusion volume; the proportion of induced acute respiratory distress syndrome (ARDS), systemic inflammatory response syndrome (SIRA), and acute renal failure (ARF) in the two groups was calculated.
Results Under the restrictive fluid resuscitation, the patient's physiological indicators tended to be more normal. In the restrictive fluid resuscitation group, the initial resuscitation time was 30.4±5.2 minutes, the initial operation time was 35.2±11.6 minutes, and the total infusion volume was 1453±85ml; less than the active fluid resuscitation group. There were 4 cases of ARDS, 3 cases of SIRA and 2 cases of ARF in the restrictive fluid resuscitation group, a total of 9 cases, accounting for 18%; less than the active fluid resuscitation group. (P<0.05).
Conclusion   In the process of first aid for traumatic hemorrhagic shock, the implementation of restrictive fluid resuscitation can effectively improve the clinical indicators of patients, shorten the resuscitation time and reduce the infusion volume, prevent related complications, and promote the improvement of the emergency effect of shock patients.