| 粟远超,张运良.限制性液体复苏对急诊创伤失血性休克病人氧消耗量及血流动力学的影响[J].安徽医药,2025,29(8):1602-1606. |
| 限制性液体复苏对急诊创伤失血性休克病人氧消耗量及血流动力学的影响 |
| Effects of limited fluids resuscitation on oxygen consumption and hemodynamics in emergency traumatic hemorrhagic shock patients |
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| DOI：10.3969/j.issn.1009-6469.2025.08.023 |
| 中文关键词: 限制性液体治疗 休克，出血性 氧消耗量 血流动力学 凝血功能 |
| 英文关键词: Restrictive fluid therapy Shock, hemorrhagic Oxygen consumption Hemodynamics Coagulation function |
| 基金项目:重庆市綦江区科技计划项目( 2023140) |
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| 中文摘要: |
| 目的探讨限制性液体复苏( LFR)应用于急诊创伤失血性休克( THS)病人对其氧消耗量及血流动力学的影响。方法选择 2022年 1月至 2023年 8月重庆市綦江区人民医院收治的急诊 THS病人 300例，利用随机数字表法分为试验组 150例、对照组 150例。对照组采用常规液体复苏治疗，试验组采用 LFR治疗。比较两组治疗后氧消耗量、氧输送量等临床指标、血流动力学水平、血气指标、凝血功能及并发症发生率。结果治疗后，试验组氧消耗量、氧输送量显著高于对照组［( 185.36±19.06) mL·min.1·m.2比( 131.23±15.21)mL·min.1·m.2(642.86±65.55)mL·min.1·m.2比( 539.65±56.69)mL·min.1·m.2］(P<0.05)，液体复苏时间显著短于对照组［(102.27±12.25)min比(，170.53±19.62)min］(P<0.05)；试验组心率显著低于对照组［(81.11±8.66)次 /分比( 87.52±9.42)次 /分］(P<0.05)，平均动脉压( MAP)、中心静脉压( CVP)显著高于对照组［( 78.02±8.59)mmHg比( 69.82±7.32) mmHg、(10.35±1.24)mmHg比( 8.69±0.95)mmHg］(P<0.05)；试验组二氧化碳分压( PaCO2)、血乳酸、凝血酶时间( TT)、凝血酶原时间(PT)、活化部分凝血活酶时间( aPTT)显著低于对照组( P<0.05)，动脉氧分压( PaO2)显著高于对照组(P<0.05)；试验组并发症发生率显著低于对照组(P<0.05)。结论对急诊 THS病人采用 LFR治疗，可有效提高病人氧供能力，改善凝血功能，效果较为理想，临床应用价值较高。 |
| 英文摘要: |
| Objective To explore the effects of limited fluids resuscitation (LFR) on oxygen consumption and hemodynamics in emer-gency traumatic hemorrhagic shock (THS) patients.Methods A total of 300 emergency THS patients admitted to Qijiang District Peo-ple's Hospital in Chongqing from January 2022 to August 2023 were selected and assigned into experimental group (150 cases) andcontrol group (150 cases) by random number table method. The control group received routine liquid resuscitation treatment, while theexperimental group received LFR treatment. The clinical indicators such as oxygen consumption and oxygen delivery, hemodynamiclevels, blood gas indicators, coagulation function, and complications were compared between the two groups after treatment. Results After treatment, the oxygen consumption and oxygen delivery in the experimental group were significantly higher than those in the con-m.2 m.2 trol group [(185.36±19.06) mL·min.1 ·vs. (131.23±15.21) mL·min.1 ·m.2, (642.86±65.55) mL·min.1 ·vs. (539.65±56.69) mL· min.1·m.2] (P<0.05), and the liquid resuscitation time was significantly shorter than that in the control group [(102.27±12.25) min vs. (170.53±19.62) min] (P<0.05); the heart rate (HR) of the experimental group was significantly lower than that of the control group[(81.11±8.66) times/min vs. (87.52±9.42) times/min] (P<0.05), while the mean arterial pressure (MAP) and central venous pressure(CVP) were significantly higher than those of the control group [(78.02±8.59) mmHg vs. (69.82±7.32) mmHg, (10.35±1.24) mmHg vs. (8.69±0.95) mmHg] (P<0.05); the partial pressure of carbon dioxide (PaCO2), blood lactate (BL), thrombin time (TT), prothrombin time(PT), and activated partial thromboplastin time (aPTT) in the experimental group were significantly lower than those in the control group(P<0.05), and arterial oxygen pressure (PaO2) was significantly higher than that in the control group (P<0.05); the incidence of compli-cations in the experimental group was significantly lower than that in the control group (P<0.05).Conclusion The LFR treatment for emergency THS patients can effectively improve their oxygen supply capacity and coagulation function, with ideal results and high clin-ical application value. |
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