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目的探讨创伤性休克早期即刻液体复苏与延迟液体复苏的临床意义。方法回顾分析40例创伤性休克患者在急诊科液体复苏1h内血检HCT、PT、APTT、BL、PH、BD值变化,比较液体复苏前后上列数值变化。结果IR组血PT、APTT均较DR组明显延长(P<0.05);IR组在第1个小时内输液量(2000±580)ml,DR组相应为(500±250)ml,输液量差异有统计学意义(P<0.05);IR组治疗后HCT明显下降(P<0.05);BL及BD在两组治疗前后差异均无统计学意义(P>0.05)。结论在创伤性休克手术前1h内进行延迟液体复苏,可以保护机体凝血系统减少继续失血,并且能够维持组织器官最低有效灌注,保持容量及酸碱代谢基本平衡。
Objective To investigate the clinical significance of immediate early liquid resuscitation and delayed fluid resuscitation in traumatic shock. Methods The changes of HCT, PT, APTT, BL, PH and BD in blood of emergency traumatic patients in 40 patients with traumatic shock were retrospectively analyzed. The above numerical values were compared before and after liquid resuscitation. Results The levels of blood PT and APTT in IR group were significantly longer than those in DR group (P <0.05). In IR group, the volume of infusion was (2000 ± 580) ml in the first hour and (500 ± 250) ml in DR group, (P <0.05). The HCT of IR group decreased significantly after treatment (P <0.05). There was no significant difference of BL and BD between the two groups before and after treatment (P> 0.05). Conclusion Delayed liquid resuscitation within 1h before traumatic shock surgery can protect the body’s coagulation system to reduce blood loss and maintain the minimum effective perfusion of tissues and organs to maintain the basic balance of acid and base metabolism.