摘要
目的对外伤性脾破裂失血量（ｈｅｍｏｒｒｈａｇｉｃｖｏｌｕｍｅ，ＨＶ）、失血速度（ｈｅｍｏｒｒｈａｇｉｃｓｐｅｅｄ，ＨＳ）与围手术期失代偿性休克（ｐｅｒｉｏｐｅｒａｔｉｖｅｄｅｃｏｍｐｅｎｓａｔｉｏｎａｌｓｈｏｃｋ，ＰＯＤＳ）以及脾破裂类型的关系，进行综合评价和对比，找出一种评价患者病情的客观指标。方法根据脾破裂患者术前时间和术中测定的ＨＶ，计算患者的ＨＳ，取其二者常用对数之乘积作为评价患者伤情的综合失血指数（ｓｙｎｔｈｅｔｉｃｈｅｍｏｒｒｈａｇｉｃｉｎｄｅｘ，ＳＨＩ），并确定不同ＨＶ、不同ＨＳ和不同ＳＨＩ与ＰＯＤＳ的对应关系，以及ＨＳ与脾破裂类型的关系。结果ＰＯＤＳ在不同ＨＶ组别间的分布差异性显著（Ｐ＜０．０５）；在不同ＨＳ组别间差异亦显著（Ｐ＜０．０５），且不同ＨＳ与脾破裂类型关系密切（Ｐ＜０．０１或近于０．０５）；在不同ＳＨＩ组别间除显示差异极显著（Ｐ＜０．０５～Ｐ＜０．０１）外，还提示出其他重要信息。结论ＨＳ与ＨＶ两者相辅相成，在脾破裂患者ＰＯＤＳ的产生上发挥重要作用，且ＨＳ与脾破裂类型关系密切；ＳＨＩ结合了ＨＳ与ＨＶ两个参数，能够对患者病情作出切实客观的评价，有利于对患者进行分析和比较，便于对病程和?
Objective To determine the effects of hemorrhagic volume (HV) and
hemorrhagic speed (HS) on perioperative decompensational shock (PODS) in the patients with
traumatic rupture of the spleen and to find an objective index to evaluate the patient's condition
and prognosis. Methods HS was obtained according to preoperative time and HV. The common
logarithmic values of both HS and HV were calculated. The product of two relevant common
logarithmic values was defined as synthetic hemorrhagic index (SHI). Then, the relationships
between HS, HV or SHI and PODS were determined, respectively. The relationship between HS
and the types of traumatic rupture of the spleen was also explored. Results Distribution
differences of PODS among groups of HS, HV or SHI were all significant statistically
(P<0.05-0.01). The relationship between HS and the types of traumatic rupture of the spleen was
intimate (P<0.05 or near 0.05). Conclusions HS has an important effect on the occurrence of
PODS, and relates closely to the types of traumatic rupture of the spleen as well. SHI makes
both parameters of HS and HV integrated, by which we can estimate the condition of the patients
exactly and objectively. It is not only convenient to make contrast among groups and
individuals but also beneficial to guide diagnosis and treatment for the patients.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
1999年第3期212-214,共3页
Chinese Journal of Trauma
关键词
脾破裂
出血
预后
综合失血指数
Splenic ruptureHemorrhagePrognosisSynthetic hemorrhagic index
