Comparison of the effects of limited fluid resuscitation and aggressive fluid resuscitation in treatment of uncontrolled hemorrhagic traumatic shock / 中国医师进修杂志

ABSTRACT

Objective To compare the effects of limited fluid resuscitation and aggressive fluid resuscitation in treatment of uncontrolled hemorrhagic traumatic shock,and to improve the cure rate.Methods One hundred and twenty patients with hemorrhagic traumatic shock on the basis of outpatient registration number of single and double were divided into limited fluid resuscitation group(limited group,56 cases) and aggressive fluid resuscitation group (positive group,64 cases),respectively.The preoperative blood lactic acid,base excess,prothrombin time,hemoglobin was compared and the preoperative infusion and the number of patients with death was recorded.Results The preoperative infusion in limited group was significantly less than that in positive group [(1 050 ± 212) ml vs.(2 120 ± 186) ml],the difference was statistically significant (P ＜ 0.01).The mortality rate in limited group was significantly lower than that in positive group [12.50％(7/56) vs.28.12％(18/64)],the difference was statistically significant (P＜ 0.05).The preoperative blood lactic acid,base excess,prothrombin time in limited group were significantly lower than those in positive group [(3.31 ± 0.29) mmol/L vs.(5.78 ± 0.15) mmol/L,(5.42 ± 1.13) mmol/L vs.(9.86 ± 1.21) mmol/L,(11.7 ± 1.9) s vs.(18.1 ± 1.7) s],and the hemoglobin in limited group was significantly higher than that in positive group [(96 ± 18) g/L vs.(83 ± 20) g/L],the differences were statistically significant (P ＜0.01).Conclusions If hemorrhage is not controlled,early limited fluid resuscitation can maintain blood perfusion of vital organs,alleviate acidosis,reduce mortality and creat good conditions for advanced treatment.Limited fluid resuscitation is superior to aggressive fluid resuscitation in operative intervention for patients with uncomtrolled hemorrhagic traumatic shock.