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目的探讨重症胸部创伤合并创伤性失血性休克(HTS)采用限制性液体复苏的治疗效果。方法总结我院胸外科收治的重症胸部创伤合并HTS患者48例,通过限制性液体复苏治疗,开通2条以上静脉通道,快速输注林格氏液或生理盐水1000ml,706代血浆(羟乙基淀粉)500ml(晶/胶比例为2～3∶1),当血压回升至70mmHg(1mmHg=0.133kPa)时,即减慢输液速度,限制晶体液输入量,每日平均输液量为(2050±350)ml。结果治愈46例,死亡2例,发生急性呼吸窘迫综合征(ARDS)4例。MODS1例。结论重症胸部创伤合并HTS采用限制性液体复苏方法救治可降低ARDS发生,提高治愈率。
Objective To investigate the therapeutic effect of restrictive fluid resuscitation on severe thoracic trauma combined with traumatic hemorrhagic shock (HTS). Methods Forty-eight patients with severe thoracic trauma complicated with HTS admitted to our hospital were enrolled. Two or more intravenous routes were opened by restrictive fluid resuscitation. Rapid infusion of Ringer’s solution or normal saline (1000ml) and 706-generation plasma (hydroxyethyl Starch) 500ml (crystal / plastic ratio of 2 ~ 3: 1), when the blood pressure rose to 70mmHg (1mmHg = 0.133kPa), which slows down the infusion rate, limiting the amount of crystal liquid input, the average daily infusion volume (2050 ± 350) ml. Results of 46 cases were cured, 2 patients died of acute respiratory distress syndrome (ARDS) in 4 cases. MODS1 cases. Conclusions Severe thoracic trauma combined with HTS treatment with restrictive fluid resuscitation method can reduce the incidence of ARDS and improve the cure rate.