限制性补给液在产后失血性休克中的应用效果
|
摘要
目的探讨限制性补给液在产后失血性休克中的应用效果。方法选取2016年3月～2018年3月我院收治的32例产妇作为研究对象,产妇均有不同程度的产后失血性休克表现,按照随机抽签法将产妇分为观察组(16例)和对照组(16例)。产妇出现休克后马上采取急救措施,观察组产妇出现休克后开通两条静脉通路,一条限制性输入氯化钠羟基乙基淀粉,根据情况对液体速度进行微调,另一条输入必要的抢救药物和抗生素;对照组进行常规液体复苏措施,利用林格液进行输液,完成后输入胶体液维持动脉压,另一条也输入抢救药物和抗生素。对产妇的输液量、出血量、输血量、治疗总有效率、平均动脉压(MAP)、红细胞比容(HCT)及中心静脉压(CVP)进行比较。结果观察组产妇在治疗过程中的输液量、出血量及输血量均明显少于对照组,差异有统计学意义(P<0.05)。观察组产妇的治疗总有效率为93.75%,高于对照组的56.25%,差异有统计学意义(P<0.05)。观察组产妇治疗后1 h的MAP、CVP、HCT均高于同组治疗后0.5 h,差异有统计学意义(P<0.05);治疗后0.5 h以及治疗后1 h,观察组产妇的MAP、CVP、HCT均高于对照组,差异有统计学意义(P<0.05)。结论对产后失血性休克产妇使用限制性补给液能减少出血量,同时也能减少输液量,保证失血性休克产妇的血流动力学稳定,纠正异常凝血功能,提升治疗成功率,值得临床上推广应用。
Objective To explore the application effect of restrictive replenishment fluid in postpartum hemorrhagic shock. Methods A total of 32 cases of maternal women who were admitted to our hospital from March 2016 to March 2018 were selected as subjects, and all of them had different degrees of postpartum hemorrhagic shock. They were divided into the observation group(16 cases) and the control group(16 cases) according to random sampling method. Firstaid measures were taken immediately after the shock occurred in the women. The observation group had two venous accesses after the shock, a restrictive input was Sodium Chloride Hydroxyethyl Starch, fine-tuning the liquid speed according to the situation, and another input was necessary rescuing drugs and antibiotics. The control group underwent routine fluid resuscitation, using Ringer′ s solution for infusion, and after completion, the colloidal fluid was input to maintain arterial pressure, the other was also entered into rescuing drugs and antibiotics. The patients′ infusion volume,blood loss, blood transfusion volume, total effective rate of treatment, mean arterial pressure(MAP), hematocrit(HCT)and central venous pressure(CVP) were compared. Results The infusion volume, blood loss and blood transfusion volume in the observation group were significantly less than those in the control group, and the differences were statistically significant(P<0.05). The total effective rate of treatment in the observation group was 93.75%, which was higher than that in the control group(56.25%), and the difference was statistically significant(P<0.05). The MAP, CVP and HCT at 1 h after treatment in the observation group were higher than that of the same group at 0.5 h after treatment,and the differences were statistically significant(P<0.05). The MAP, CVP and HCT of the maternal women in the observation group were higher than those in the control group at 0.5 h after treatment and 1 h after treatment, and the differences were statistically significant(P<0.05). Conclusion The use of restrictive replenishment fluid for postpartum hemorrhagic shock can reduce the amount of bleeding, and also reduce the amount of infusion, which can ensure hemodynamic stability of hemorrhagic shock, correct abnormal coagulation function and improve treatment success rate, and it is worthy of clinical application.
Objective To explore the application effect of restrictive replenishment fluid in postpartum hemorrhagic shock. Methods A total of 32 cases of maternal women who were admitted to our hospital from March 2016 to March 2018 were selected as subjects, and all of them had different degrees of postpartum hemorrhagic shock. They were divided into the observation group(16 cases) and the control group(16 cases) according to random sampling method. Firstaid measures were taken immediately after the shock occurred in the women. The observation group had two venous accesses after the shock, a restrictive input was Sodium Chloride Hydroxyethyl Starch, fine-tuning the liquid speed according to the situation, and another input was necessary rescuing drugs and antibiotics. The control group underwent routine fluid resuscitation, using Ringer′ s solution for infusion, and after completion, the colloidal fluid was input to maintain arterial pressure, the other was also entered into rescuing drugs and antibiotics. The patients′ infusion volume,blood loss, blood transfusion volume, total effective rate of treatment, mean arterial pressure(MAP), hematocrit(HCT)and central venous pressure(CVP) were compared. Results The infusion volume, blood loss and blood transfusion volume in the observation group were significantly less than those in the control group, and the differences were statistically significant(P<0.05). The total effective rate of treatment in the observation group was 93.75%, which was higher than that in the control group(56.25%), and the difference was statistically significant(P<0.05). The MAP, CVP and HCT at 1 h after treatment in the observation group were higher than that of the same group at 0.5 h after treatment,and the differences were statistically significant(P<0.05). The MAP, CVP and HCT of the maternal women in the observation group were higher than those in the control group at 0.5 h after treatment and 1 h after treatment, and the differences were statistically significant(P<0.05). Conclusion The use of restrictive replenishment fluid for postpartum hemorrhagic shock can reduce the amount of bleeding, and also reduce the amount of infusion, which can ensure hemodynamic stability of hemorrhagic shock, correct abnormal coagulation function and improve treatment success rate, and it is worthy of clinical application.
引文
[1]何玉芳.产后失血性休克治疗体会[J].中外医疗,2009,28(14):22.
[2]黄志聪,罗海杰,梁少映.骨髓腔输液在创伤失血性休克急救中的应用观察[J].实用中医药杂志,2017,33(3):298-299.
[3]严文萍,张婷,孙燕.产后出血急性失血性休克抢救护理流程在手术室中的应用[J].实用临床医药杂志,2017,21(18):189-191.
[4]赖莲花.休克指数与阴道分娩产妇产后出血量及失血性休克发生率的关系[J].包头医学院学报,2017,33(7):59-60.
[5]赵海英,王鑫,占永红.不同补液方式对创伤合并失血性休克患者早期急救的影响[J].当代医学,2017,23(14):92-94.
[6]刘宝霞,马振峰.产后失血性休克的原因及预防[J].职业与健康,2006,22(14):1117-1118.
[7]杨翠英,张淑婷,吴晓瑜,等.限制性输液复苏在产后失血性休克中的应用研究[J].安徽医学,2014,35(5):576-578.
[8]樊金汶.改良的骨通道补液在急诊救治中的应用价值[J].中国卫生标准管理,2017,8(20):73-75.
[9]温穗文,郭晓燕,黄旭君,等.限制性液体复苏对产后失血性休克患者血流动力学及凝血功能的影响[J].广东医学,2014,35(21):3335-3337.
[10]李琴.产后出血早期失血性休克的个性化护理方案分析[J].健康必读(下旬刊),2018,11(4):181.
[11]祁建青,白旭明,王敬华,等.两种不同方法治疗产后出血所致不同程度休克的临床疗效对比及DSA影像特点[J].中国妇产科临床杂志,2017,18(3):248-249.
[12]江海湛.产后出血失血性休克抢救中限制性补液疗法的应用价值分析[J].中国医学创新,2016,13(6):18-21.
[13]郭亚丽.限制性液体复苏结合成分输血在抢救产后出血失血性休克中的应用[J].中国药物与临床,2012,12(10):1367-1368.
[14]沙小龙,王倩.限制性补液疗法在抢救产后出血失血性休克患者中的应用[J].中国医学创新,2014,11(28):56-58.
[15]魏姜梅.产后阴道壁血肿致失血性休克2例[J].中外医疗,2011,30(8):88.
[2]黄志聪,罗海杰,梁少映.骨髓腔输液在创伤失血性休克急救中的应用观察[J].实用中医药杂志,2017,33(3):298-299.
[3]严文萍,张婷,孙燕.产后出血急性失血性休克抢救护理流程在手术室中的应用[J].实用临床医药杂志,2017,21(18):189-191.
[4]赖莲花.休克指数与阴道分娩产妇产后出血量及失血性休克发生率的关系[J].包头医学院学报,2017,33(7):59-60.
[5]赵海英,王鑫,占永红.不同补液方式对创伤合并失血性休克患者早期急救的影响[J].当代医学,2017,23(14):92-94.
[6]刘宝霞,马振峰.产后失血性休克的原因及预防[J].职业与健康,2006,22(14):1117-1118.
[7]杨翠英,张淑婷,吴晓瑜,等.限制性输液复苏在产后失血性休克中的应用研究[J].安徽医学,2014,35(5):576-578.
[8]樊金汶.改良的骨通道补液在急诊救治中的应用价值[J].中国卫生标准管理,2017,8(20):73-75.
[9]温穗文,郭晓燕,黄旭君,等.限制性液体复苏对产后失血性休克患者血流动力学及凝血功能的影响[J].广东医学,2014,35(21):3335-3337.
[10]李琴.产后出血早期失血性休克的个性化护理方案分析[J].健康必读(下旬刊),2018,11(4):181.
[11]祁建青,白旭明,王敬华,等.两种不同方法治疗产后出血所致不同程度休克的临床疗效对比及DSA影像特点[J].中国妇产科临床杂志,2017,18(3):248-249.
[12]江海湛.产后出血失血性休克抢救中限制性补液疗法的应用价值分析[J].中国医学创新,2016,13(6):18-21.
[13]郭亚丽.限制性液体复苏结合成分输血在抢救产后出血失血性休克中的应用[J].中国药物与临床,2012,12(10):1367-1368.
[14]沙小龙,王倩.限制性补液疗法在抢救产后出血失血性休克患者中的应用[J].中国医学创新,2014,11(28):56-58.
[15]魏姜梅.产后阴道壁血肿致失血性休克2例[J].中外医疗,2011,30(8):88.