纠正亚低温联合限制性液体复苏在严重腹部创伤合并失血性休克中的应用

目的:探讨纠正亚低温联合限制性液体复苏在严重腹部创伤合并失血性休克的应用效果。方法:回顾性分析150例严重腹部创伤合并失血性休克患者，其中采用纠正亚低温联合限制性液体复苏者50例（A组），限制性液体复苏者50例（B组），传统液体复苏者50例（C组）。对比3组患者的输液量、凝血酶原时间（PT）、患者存活率、病死率及并发症发生情况。结果:3组患者术前输液量及PT差异均有统计学意义（P<0.01），C组和B组补液量和PT均高于A组（P<0.01）；A、B和C组的病死率分别为17.8%、27.9%、37.5%，差异有统计学意义（P<0.05）。3组出现的并发症主要是急性肾功能衰竭、急性呼吸窘迫综合征、弥散性血管内凝血、多脏器功能障碍综合征，3组总并发症发生率分别为18.2%、57.9%、63.6%，但3组患者各项并发症发生率差异均无统计学意义（P>0.05）。结论:纠正亚低温联合限制性液体复苏可改善严重腹部创伤合并失血性休克患者的凝血功能，降低患者病死率，值得临床推广。

The application effect of subhypothcrmia correction combined with limited liquid resuscitation in severe abdominal trauma complicated with hemorrhagic shock

Objective:To investigate the application effects of subhypothcrmia correction combined with limited liquid resuscitation in severe abdominal trauma complicated with hemorrhagic shock. Methods:The clinical data of 150 patients with severe abdominal trauma complicated with hemorrhagic shock were retrospectively analyzed. Fifty cases were treated with subhypothcrmia correction combined with limited liquid resuscitation( group A) ,50 cases were treated with limited liquid resuscitation( group B) ,and 50 cases were treated with traditional liquid resuscitation ( group C ) . The amount of infusion and prothrombin time ( PT ) , survival rate, incidence of complication and mortality between three groups were compared. Results:The differences of the preoperative infusion amount and PT between three groups were statistically significant(P<0. 01),and which in group B and group C was higher than that in group A(P<0. 01). The mortalities in groups A,B and C were 17. 8%,27. 9% and 37. 5%,respectively,the difference of which was statistically significant(P<0. 05). The acute renal failure,acute respiratory distress syndrome,diffuse intravascular coagulation and multiple organ dysfunction syndrome were the main complications in groups A, B and C, and the total incidence rates in groups A, B and C were 18.2%,57.9% and 63. 6%,respectively,the difference of which was not statistically significant(P >0. 05). Conclusions:The subhypothcrmia correction combined with limited liquid resuscitation can improve the blood coagulation function, and reduce the mortality of patients with severe abdominal trauma complicated with hemorrhagic shock,which is worthy of clinical promotion.