创伤性休克液体复苏的探讨

目的：探讨液体复苏对创伤性休克患者的救治效果。方法：回顾性总结1989年1月-2002年12月我院急诊科256例严重创伤患者来院1h内液体复苏与创伤性休克预后的量效关系。结果：256例创伤性休克患者中复苏成功率为73．05％(187例)，创伤病死率为26．95％(69例)。创伤后1h内复苏液体量≤1L者存活率为52．27％，1．5～2．0L者存活率为75．90％，≥2．0L者存活率为78．29％。轻度休克者存活率为86．79％，中度休克者存活率为80．34％，重度休克者存活率为54．65％。结论：严重创伤、重度休克、长时间低血压非正确休克复苏是影响休克救治效果的主要因素；早期合理地扩容，把握创伤后第1h黄金时刻，是复苏成功的关键；而稳定血流动力学、纠正氧债是休克复苏的目标。

Fluid resuscitation in traumatic shock

Objective: To investigate fluid resuscitation affecting the result of treatment of patients with traumatic shock. Methods: Two hundred and fiftysix cases of patients with traumatic shock treated in our hospital between January 1989 and December 2002 were analysed retrospectively, and the volumeeffect relationship between fluid resuscitation during the first hour and future of traumatic shock was summarised . Results : The successful rate of resuscitation was 73 05 percent(187 cases), and traumatic mortality was 26 95 percent ( 69 cases ). After 1hour trauma, the survival rate was 52 27 percent in patients with 1 liter of resuscitation fluid , 75 90 percent in patients with 1 52 0 liter of resusictation fluid, and 78 29 percent of more than 2 0 liter resuscitation fluid, 86 79 percent in mild shock, 80 34 percent in middle shock and 54 65 percent in severe shock. Conclusion: Severe trauma and shock, hypotension and incorrect resuscitation manipuation are the main factors affecting the result of resuscitation and treatment of traumatic shock. It is important to early and correctly expand, especially at the first hour. The aim of resuscitation of traumatic shock is to maintain the hemodynamics and correct O 2 defect.