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1、骨盆型严重多发伤失血性休克的限制性容量复苏的论文【摘要】目的通过采集骨盆型严重多发伤的病例资料,总结和分析其病情特点,为临床上骨盆型严重多发伤应用损害控制提供初步依据。方法对我院2000年1月~2007年7月间的60例骨盆型严重多发伤患者进行回顾性研究。对其中21例伴有失血性休克患者通过损伤严重度评分(iss)、早期复苏输液量、复苏时间等指标进行量化分析和疗效评估。结果21例伴有失血性休克,根据早期复苏方法分为限制性复苏组(11例)和常规复苏组(10例)。限制性复苏组:iss评分30.72,复苏输液量1009.09ml,复苏时间102.72分钟,复苏后血红蛋白
2、(hgb)98.36g/l;常规复苏组:iss评分30.90,复苏输液量3175ml,复苏时间246分钟,复苏后hgb79.90g/l。限制性复苏组和常规复苏组iss评分无显著性差异(p>0.05),复苏输液量、复苏时间、复苏后hgb均有显著性差异(p<0.05)。结论在急救复苏过程中,对伴有失血性休克的骨盆型严重多发伤患者进行限制性复苏,能使输液量更少,控制出血更好,复苏效果更显著。【关键词】骨盆骨折;多发伤;损伤评分;容量复苏;损害控制alimitedresuscitationforseverepolytraumapatientsplicate
3、d orrhagicshock ing,luoxiaobo,duquanyin,etal. (departmentoforthopaedics,instituteofsurgeryresearch,dapinghospital,thirdmilitarymedicaluniversity, chongqing400042,china) abstract:objectivetocollectthedataofseverepolytraumapatientsainlysustainedpelvictrauma,andtoanalyzeandsumma
4、rizethefeatureofitspathogeiccondition,thenprovideinitialevidencefortreatmentbyapplyingdamagecontrol.methodstotally60severepolytraumapatientsainlysustainedpelvictraumainourdepartmentbeteof21ofthemorrhagicshockorrhagicshock.theyitedresuscitationgroupandroutineresuscitationgroupaccordi
5、ngtoearlyresuscitationmethod.thelimitedresuscitationgroupshoe1009.09ml,averageresuscitationtime102.72minutes,averagehgbafterresuscitation98.36g/l.theroutineresuscitationgroupshoe3175.00ml,averageresuscitationtime246.00minutes,averagehgbafterresuscitation79.90g/l.betitedresuscitation
6、groupandtheroutineresuscitationgroup,theree(p<0.05),theresuscitationtime(p<0.05),thehgbafterresuscitation(p<0.05).conclusionduringtheemergencyresuscitation,theseverepolytraumapatientsainlysustainedpelvictraumaacpaniedorrhagicshockaretreatedbythelimitedresuscitation,e,better
7、controlhemorrhage,andmaketheresuscitationeffectmoreremarkable. keya;injuryscore;resuscitation;damagecontrol 骨科以骨盆骨折为主的严重多发伤病情凶险复杂,常合并多部位多器官损伤,大量出血,休克发生率较高,危及伤员健康和生命。.在失血性休克急救早期,采用限制性容量复苏,并与常规早期充分容量复苏比较,具有更好的疗效和更低的临床风险。临床资料 1一般资料 将骨盆型严重多发伤定义为以骨盆骨折为主,其简明损伤定级(ais)≥4分,损伤严重度评分(iss)≥1
8、7分的严重多发性损伤。2000年1月~