| 李大扣,汪东亮,史 宇,张万钦,姚 磊.限制性液体复苏对多发性骨折合并创伤失血性休克患者凝血功能、心肌损害指标及预后的影响[J].,2023,(24):4706-4709 |
| 限制性液体复苏对多发性骨折合并创伤失血性休克患者凝血功能、心肌损害指标及预后的影响 |
| The Effect of Restrictive Fluid Resuscitation on Coagulation Function, Myocardial Damage Indicators, and Prognosis in Patients with Multiple Fractures Combined with Traumatic Hemorrhagic Shock |
| 投稿时间：2023-05-17 修订日期：2023-06-13 |
| DOI：10.13241/j.cnki.pmb.2023.24.021 |
| 中文关键词: 限制性液体复苏 多发性骨折 创伤失血性休克 凝血功能 心肌损害 预后 |
| 英文关键词: Limited fluid resuscitation Multiple fractures Taumatic hemorrhagic shock Coagulation Myocardial damage Prognosis |
| 基金项目:江苏省健康科研研究项目（F202298） |
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| 中文摘要: |
| 摘要 目的：研究限制性液体复苏对多发性骨折合并创伤失血性休克患者凝血功能、心肌损害指标及预后的影响。方法：选择2020年6月至2022年5月的90例多发性骨折合并创伤失血性休克患者进行本次研究，按照随机数表法分为研究组（n=47）和对照组（n=43），对照组采用常规液体复苏治疗，研究组采用限制性液体复苏治疗。对比两组输液量、失血量、输血量，复苏前及复苏后1 h凝血功能指标（PT、APTT、TT）水平，心肌损害指标（CK、CK-MB、CTnT）水平，并发症发生率。结果：研究组输液量、失血量、输血量均显著低于对照组[（2106.87±135.62）mL vs（2950.39±139.57）mL，（1049.31±160.07）mL vs（1390.18±135.89）mL，（1465.02±191.78）mL vs（1860.23±198.59）mL]（P＜0.05）；研究组PT、 APTT、 TT水平均显著高于对照组[（19.06±1.80）s vs（15.82±1.26）s，（42.03±3.85）s vs（37.02±3.19）s，（21.03±3.86）s vs（15.80±3.27）s]（P＜0.05）；研究组CK、CK-MB、CTnT水平均显著低于对照组[（20.85±2.72）U/L vs（32.97±3.69）U/L，（23.06±3.28）U/L vs（35.97±3.70）U/L，（2.07±0.36）ng/mL vs（2.90±0.38）ng/mL]（P＜0.05）；研究组并发症发生率显著低于对照组[10.64%（5/47）vs27.91％（12/43）]（P＜0.05）。结论：多发性骨折合并创伤失血性休克患者采用限制性液体复苏可有效改善的其凝血功能，保护心肌细胞，提高患者预后。 |
| 英文摘要: |
| ABSTRACT Objective: To study the effect of restrictive fluid resuscitation on coagulation function, myocardial damage indicators, and prognosis in patients with multiple fractures combined with traumatic hemorrhagic shock. Methods: 90 in patients with multiple fractures combined with traumatic hemorrhagic shock who received treatment in our hospital from June 2020 to May 2022 were selected for this study, according to random number table method, they were divided into study group (n=47) and control group (n=43), the control group received routine liquid resuscitation treatment, on the basis of the control group, the research group used restrictive fluid resuscitation therapy. Compare the infusion volume, blood loss, transfusion volume, coagulation function indicators (PT, APTT, TT) levels before and 1 hour after resuscitation, myocardial damage indicators (CK, CK-MB, CTnT) levels, and incidence of complications between the two groups. Results: The infusion volume, blood loss, and transfusion volume of the research group were significantly lower than those of the control group [(2106.87±135.62) mL vs(2950.39±139.57) mL, (1049.31±160.07) mL vs (1390.18±135.89) mL, (1465.02±191.78) mL vs(1860.23±198.59)mL] (P＜0.05). The levels of PT, APTT, and TT in the study group were significantly higher than those in the control group [(19.06±1.80) s vs (15.82±1.26) s, (42.03±3.85) s vs (37.02±3.19) s, (21.03±3.86) s vs (15.80±3.27) s] (P＜0.05). The levels of CK, CK-MB, and CTnT in the study group were significantly lower than those in the control group [(20.85±2.72)U/L vs (32.97±3.69)U/L, (23.06±3.28)U/L vs (35.97±3.70)U/L, (2.07±0.36) ng/mL vs (2.90±0.38) ng/mL] (P＜0.05). The incidence of complications in the study group was significantly lower than that in the control group [10.64%(5/47) vs 27.91％(12/43)] (P＜0.05). Conclusion: Restrictive fluid resuscitation can effectively improve the coagulation function, protect myocardial cells and improve the prognosis of patients with multiple fractures and traumatic hemorrhagic shock. |
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