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目的:探讨不同的液体复苏对晚期血吸虫病上消化道大出血低血容量性休克的应用效果。方法:将313例晚期血吸虫病上消化道大出血低血容量性休克患者,随机分成充分液体复苏组(153例)和限制液体复苏组(160例),比较其凝血功能,并发症发生率、病死率已及住院天数。结果:2h内充分液体复苏组病死率37.9%,限制液体复苏组病死率25%,两组2h病死率和住院天数比较差异有统计学意义(P<0.01),充分液体复苏组血浆凝血酶原时间延长,血小板呈进行性下降,存活患者并发症的发生率显著高于限制性液体复苏组(P<0.01)。限制液体复苏组存活患者住院天数明显缩短(P<0.01)。结论:限制性液体复苏能降低晚期血吸虫病上消化道大出血低血容量性休克患者病死率,提高生存率,同时降低并发症的发生率,减少住院天数,改善预后。
Objective: To investigate the effect of different liquid resuscitation on hypovolemic shock in patients with advanced schistosomiasis. Methods: A total of 313 patients with schistosomiasis upper gastrointestinal hemorrhagic hypovolemic shock were randomly divided into adequate liquid resuscitation group (n = 153) and liquid resuscitation group (n = 160). The incidences of coagulation, complication rates, and mortality were compared Rate and hospitalization days. Results: The mortality rate of liquid resuscitation group was 37.9% within 2 h, and the mortality rate of liquid resuscitation group was limited to 25%. There was significant difference between 2 h mortality rate and hospitalization days (P <0.01) Prolonged, thrombocytopenia decreased, and the incidence of complications in survivors was significantly higher than that in the limited fluid resuscitation group (P <0.01). The number of hospital stay in patients who survived liquid resuscitation was significantly shorter (P <0.01). CONCLUSIONS: Restrictive fluid resuscitation can reduce the mortality and improve the survival rate of patients with hemorrhagic shock due to upper gastrointestinal hemorrhagic shock in advanced schistosomiasis. At the same time, it can reduce the incidence of complications, reduce the length of hospital stay and improve the prognosis.