控制性升压与限制性液体复苏应用于ICU多发伤休克患者中的价值

DOI :10.16662/j .cnki .l 674-0742.2017.08.111

临床医学 -------------2017 NO.8

China &Foreign Medical Treatment 中外医疗控制性升压与限制性液体复苏应用于ICU

多发伤休克患者中的价值

施剑

江苏省海门市人民医院重症医学科，江苏海门226100

[摘要]目的探析对IC U 多发伤休克患者采取控制性升压与限制性液体复苏的临床价值。方法方便选取该院2011年 1月一2016年11月期间收治的102例IC U 多发伤休克患者，均采取控制性升压，根据不同的复苏方法将其分为两 组，研究组和对照组，各51例，对照组采取常规液体复苏，研究组给予限制性液体复苏，比较两组复苏时间、临床效果 及并发症情况。结果研究组复苏时间（90.0±25.3)m in 、复苏后P T (10.1±1.1)s 、复苏后C -反应蛋白（101.2±11.6)ng/L ， 复苏后H gb(102.7±12.6)g/L 、复苏后CV P(7.3±1.1)cm H 2〇与对照组比较差异有统计学意义(P <0.05);研究组D IC 发生 率11.76%、M O D S 发生率5.88%、病死率1.96%与对照组比较差异有统计学意义(P <0.05)。结论对IC U 多发伤休克

患者采取控制性升压与限制性液体复苏疗效明确，安全性好，值得临床应用。[关键词]ICU 曰多发伤休克；限制性液体复苏

[中图分类号]R459 [文献标识码]A [文章编号]1674-0742(2017)03(b )-0111-03

Value of Damage Control Recovery and Limited Fluid Resuscitation in Pa-tients with Multi-wound Shock in ICU

SHI Jian ICU, H aim en People,s Hospital, Haim en, Jiangsu Province, 226100 China

[A bstract] O bjective To study the clinical value of dam age control recovery and lim ited fluid resuscitation in patients with m ulti-w ound shock in ICU. M ethods 102 cases of patients with m ulti-w ound shock in ICU adm itted and treated in our hos-pital from January 2011 to November 2016 were conveniently selected and adopted the dam age control recovery, and divided into two groups with 51 cases in each according to different recovery methods the control group adopted the routine fluid re-covery, while the research group adopted the lim ited fluid recovery, and the recovery tim e, clinical effect and complications were com pared between the two groups. R esults The recovery time, PT after recovery, C -reactive protein after recovery and Hgb and CVP after recovery in the research group were respectively(90.0±25.3)m in ，(10.1±1.1)s ，(101.2±11.6)ng/L ，(102.7土 12.6)g/L and (7.3±1.1)cm H 2〇, and the differences had statistical significance compared with those in the control group (P< 0.05), and the incidence rate of DIC and MODS and morbidity rate in the research group were respectively 11.76%, 5.88% and 1.96%, and the differences between groups had statistical significance (P<0.05). C onclusion The curative effect of dam -age control recovery and lim ited fluid resuscitation in patients with m ulti-w ound shock in ICU is definite with good safety, which is worth clinical application.

[K ey w ords] ICU; M ulti-w ound shock; Limited fluid recovery

在临床上，ICU 多发伤休克是比较常见的急危重

症，在初诊时，多数患者原发性疾病严重，伴有活动性

出血，难以控制，危及患者生命安全[1]。对于严重创伤患

者早期大量输人不合理的液体与血量，不仅会导致机

体内环境紊乱，还会出现很多并发症[2]。随着临床上对

休克的发生机制认识不断提高，采取控制性升压与限[作者简介]施剑(1973-)，男

，江苏海门人，本科，副主任医师， 研究方向:创伤。制性液体复苏方法救治患者，获得良好效果，该文笔者 为进一步探析其临床价值，将2011年1月一2016年 11月期间收治的102例ICU 多发伤休克患者，作为研 究对象，现报道如下。1资料与方法1.1 一般资料

方便选取该院收治的102例ICU 多发伤休克患

者。根据不同的复苏方法将其分为两组，研究组和对照China &Foreign Medical Treatment 中外医疗 111