限制性液体复苏治疗胸部创伤失血性休克分析

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。

Effect of Limited Fluid Resuscitation on Patients with Hemorrhagic Shock after Chest Trauma

Objective To explore the effect of limited fluid resuscitation on patients with acute hemorrhagic traumatic shock （HTS） after severe thoracic trauma. Methods 48 acute HTS patients were treated by limited fluid resuscitation in thoracic surgery of our hospital. Ringer＇ s solution or normal saline 1 000 ml and 706 plasma substitutes 500 ml（ Crystal/plastic ratio 2： 1- 3： 1 ） were infused rapidly. When the blood pressure back to 70 mm Hg, slow down the infusion and restrict the input of liquid. The average input amount is about（2 050 ± 350） ml. Results 46 patients were cured,2 of them died. 4 ARDS and 1 MODS occurred. Conclusion Llimited fluid resuscitation can reduce the occurrence of ARDS,and improve the cure rate of acute HTS.