检验医学与临床2016，Vol.13Issue(5)：614-616,3.DOI:10.3969/j.issn.1672-9455.2016.05.015
限制性液体复苏联合舒芬太尼对创伤失血性休克患者院前急救的影响
Influence of limited liquid resuscitation combined with sufentanil on pre-hospital first aid in patients with traumatic hemorrhagic shock
摘要
Abstract
Objective To investigate the influence of limited liquid resuscitation combined with sufentanil on pre‐hospital first aid in the patients with traumatic hemorrhagic shock .Methods 90 patients with traumatic hemor‐rhagic shock succeeded by pre‐hospital first aid in the Changshou District People′s from May 2011 to May 2014 were retrospectively analyzed and divided into the limited liquid resuscitation combined with sufentanil group (group A) , limited liquid resuscitation group (group B) and conventional fluid replacement resuscitation group (group C) ,30 ca‐ses in each group .The group A was given the limited liquid resuscitation for making the mean arterial pressure (MAP) at about 50 mm Hg ,meanwhile giving sufentanil 1 - 5 μg/kg by intravenous injection for 2 min ,making the patients pain digital score below 3 points ;the group B was given the limited liquid resuscitation for maintaining MAP at about 50 mm Hg ;the group C was given the sufficient fluid resuscitation for maintaining MAP at about 70 mm Hg without analgesic treatment .The liquid resuscitation amount ,prothrombin time (PT ) ,hemoglobin (Hb) level ,oxy‐genation index(PaO2 /FiO2 ) ,blood lactic acid(BLAC) level were observed on the admission to the emergency depart‐ment ;the total blood transfusion amount at 48 h after admission to ICU ,C‐reactive protein(CRP) and cortisol level at 12 h after injury were also observed .Results The fluid infusion amount on admission to the emergency department in the group A and B were significantly smaller than those in the group C ,the PT elevation degree was lower ,the Hb decrease degree was lighter ,the difference was statistically significant (P < 0 .05) ;moreover the PaO2 /FiO2 index in the group A was higher than that in the group B and C ,while the BLAC level was lower ,the difference was statisti‐cally significant(P< 0 .05) ;after admission to ICU ,the 48 h blood transfusion amount in the group A was less than those in the group B and C ,the CRP and cortisol levels at 12 h after injury ,which reflecting the body stress state , were lower ,the difference was statistically significant (P < 0 .05) .Conclusion The limited liquid resuscitation com‐bined with sufentanil for rescuing the patients with traumatic hemorrhagic shock can reduce the amount of fluid re ‐suscitation ,decreases the bleeding amount ,alleviates the traumatic stress reaction ,thus reduces the possibility of trauma caused multiple organ insufficiency .关键词
限制性液体复苏/舒芬太尼/创伤失血性休克/院前急救Key words
limited liquid resuscitation/sufentanil/traumatic hemorrhagic shock/pre-hospital first aid引用本文复制引用
王鹏,石墩义,马伟,王斌,祝茂盛,余锋..限制性液体复苏联合舒芬太尼对创伤失血性休克患者院前急救的影响[J].检验医学与临床,2016,13(5):614-616,3.基金项目
重庆市长寿区科技计划项目（CS2015044）。 （）
