腹部创伤致失血性休克患者围手术期容量治疗观察

目的探讨腹部创伤致失血性休克患者围手术期容量治疗的效果。方法选择50例急症ASAⅡ~Ⅳ级腹部创伤致失血性休克患者,视不同出血量,给予乳酸林格氏液、琥珀酰明胶进行扩容;严重失血红细胞压积<24%者,加用输血、纠酸、强心、利尿综合治疗。观察记录术中输液量、输液种类、输血量及患者生命体征变化,并计算休克指数。结果手术时间为(204±69)m in,患者入手术室至拔除气管导管时间为(257±92)m in;术中输入晶体液乳酸林格氏液(1 100±220)mL,琥珀酰明胶(900±145)mL;50例均平稳渡过围手术期,各观察指标明显改善;与术前比较,术后收缩压、舒张压、平均动脉压、中心静脉压、脉搏血氧饱和度、血红蛋白、红细胞压积均显著升高(P<0.05),心率显著减慢(P<0.05),休克指数显著降低(P<0.05)。结论合理的容量治疗可以补充失血性休克的循环血容量,改善患者的休克状态和转归。

Capacity in the treatment of hemorrhagic shock by abdominal trauma in perioperative period

Objective To investigate the effectiveness of capacity in the treatment of hemorrhagic shock by abdominal trauma in perioperative period.Methods Fifty patients with hemorrhagic shock by abdominal trauma of ASA Ⅱ-Ⅳ levels,were given Lactated Ringer′S Solution and Succinylated Gelatin for fluid expansion depending on amount of bleeding;combined with blood transfusion,correct acid,cardiotonic,diuresis treatment for those of hematocrit less than 24%.Results Operation time was（204±69）min,the time form patients into the operating room to the removal of endotracheal tube was（257±92）min;the input of lactate Ringer′s solution intraoperative was（1 100±220）mL,and Succinylated Gelatin was（900±145）mL;All of patients through Smoothly the perioperative period,each observation indicators improved obviously;Compared with the preoperative,postoperative SBP,DBP,MAP,CVP,SPO2,Hb and Hct were increased significantly（P〈0.05）,HR slow down significantly（P〈0.05）,Shock index decreased significantly（P〈0.05）.Conclusion The reasonable capacity can be added to the circulating blood volume in the treatment of hemorrhagic shock,and improve the patient′s state of shock and vesting.