Effect and prognosis of patients with hemorrhagic shock after severe trauma in emergency surgery treated with different fluid resuscitation methods
Objective To analyze the effect of different fluid resuscitation methods on the prognosis of patients with severe traumatic hemorrhagic shock in emergency surgery.Methods A analysis was performed on 64 patients with severe traumatic hemorrhagic shock who received in the Emergency department of the First Affiliated Hospital of Air Force Medical University from May 2022 to May 2024,including 38 males and 26 females,aged(39.4±4.7)years old,aged 22 to 62 years old.According to different resuscitation methods,patients were divided into adequate group(adequate emergency fluid resuscitation method,n=31)and restricted group(limited emergency fluid resuscitation method,n=33).The indexes before and after resuscitation were compared between the two groups Clinical indexes including nitric oxide(NO),residual base(BE),serum lactic acid(BLA),oxygen metabolism indexes including mixed venous oxygen saturation(SvO2),oxygen consumption(VO2),oxygen delivery(DO2),coagulation function including activated partial thromboplastin time(aPTT),prothrombin time(PT),and coagulation of the two groups were compared before and after resuscitation Enzyme time(TT)and prognosis during resuscitation.Results Before resuscitation,there was no significant difference in the levels of NO,BE,BLA,SvO2,VO2,DO2,aPTT,PT and TT between 2 groups(P＞0.05).After resuscitation,the levels of NO,BE and BLA in both groups decreased significantly,and the levels of NO and BLA in the restricted group were lower than those in the adequate group,and the levels of BE were higher than those in the adequate group.SvO2,VO2,DO2 were significantly increased in both groups,and the improvement was more significant in the restricted group.aPTT,PT and TT were significantly shortened in both groups,and the extent of shortening was more obvious in the restricted group,with statistical significance(P＜0.05).The total incidence of complications in restricted group was significantly lower than that in sufficient group,with statistical significance(P＜0.05).Conclusion In patients with severe traumatic hemorrhagic shock,limited fluid resuscitation is more effective than full fluid resuscitation,which can effectively maintain blood perfusion of important organs,significantly regulate oxygen metabolism,improve coagulation function,and significantly reduce complications in patients.
万方数据
维普
