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目的:探讨经骨髓腔输注3%高渗盐水在创伤失血性休克患者早期液体复苏中的应用。方法:2015-04-2016-02将47例创伤失血性休克患者分为骨髓腔通路组(IO组)和外周静脉通路组(IV组),使用3%高渗盐进行液体复苏,对比2组患者建立通道时间、液体复苏前及之后30、60min时平均动脉压、血压、心率、电解质变化,观察治疗期间不良反应、后期MODS及病死率情况。结果:IO组建立输液通路时间显著性少于IV组(P<0.01),2组在液体复苏后30min升压效果达到峰值,但2组间各时间点血压回升差异无统计学意义,2组均未见明显不良反应,2组在液体复苏前后电解质改变及MODS、病死率差异无统计学意义。结论:在创伤失血性休克患者早期液体复苏中经骨髓腔通路与外周静脉通路输注3%高渗盐水均有助于提高和维持血压,但经骨髓腔通路输液更迅速、方便,是建立危重患者急救液体通道的可行方法。
Objective: To investigate the application of intrabronchial infusing 3% hypertonic saline in early liquid resuscitation in patients with traumatic hemorrhagic shock. METHODS: Forty-seven patients with traumatic hemorrhagic shock were divided into the bone marrow access group (IO group) and the peripheral vein access group (IV group), and the rats were treated with 3% hypertonic saline for liquid resuscitation. The time of channel establishment, mean arterial pressure, blood pressure, heart rate and electrolytes at 30 and 60 minutes before and after fluid resuscitation were observed. The adverse reaction during treatment, MODS and mortality in later period were observed. Results: The time of establishment of infusion channel in IO group was less than that of IV group (P <0.01), and the peak effect of 30 minutes after liquid resuscitation peaked in two groups, but there was no significant difference between two groups No obvious adverse reactions were observed in both groups before and after liquid electrolyte change and MODS, mortality was no significant difference. CONCLUSION: Infusion of 3% hypertonic saline via the medullary canal and peripheral venous access during early fluid resuscitation in patients with traumatic hemorrhagic shock contributes to the improvement and maintenance of blood pressure. However, transfusion through the medullary canal is more rapid and convenient, and is critical A viable approach to emergency patient fluid access.