摘要
目的探讨以脑改良氧利用率(BMO 2UC)为导向液体复苏对重型颅脑损伤合并休克患者血流动力学、凝血功能及预后等的影响。方法选取自2016年1月至2019年12月收治的60例重型颅脑损伤合并休克患者为研究对象。根据液体复苏手段的不同分为常规组(采用传统液体复苏治疗)与观察组(采用BMO 2UC为导向液体复苏治疗),每组各30例,比较两组患者液体复苏2 d后总补液量、血流动力学指标、凝血指标及治疗2周的预后情况。结果复苏2 d后,观察组患者的总补液量明显少于常规组,平均动脉压、血压波幅水平显著低于常规组,两组间比较,差异有统计学意义(P<0.05)。复苏2 d后,两组患者的凝血酶时间、血浆凝血酶原时间及活化部分凝血活酶时间等凝血指标均明显改善,且观察组患者的各凝血指标均明显低于常规组,差异均有统计学意义(P<0.05)。治疗2周后,观察组患者的美国国立卫生院神经功能缺损评分明显低于常规组,而格拉斯哥昏迷评分明显高于常规组,两组间比较,差异均有统计学意义(P<0.05)。结论以BMO 2UC为导向液体复苏治疗颅脑损伤合并休克患者的疗效显著,可明显改善患者的预后。
Objective To investigate the effect of modified oxygen utilization coefficient(BMO 2UC)on hemodynamics,coagulation function and prognosis of patients with severe craniocerebral injury complicated with shock.Methods A retrospective study was performed on 60 cases of patients with severe craniocerebral injury with shock who were admitted from January 2016 to December 2019.According to the different methods of fluid resuscitation,the patients were divided into the conventional group(traditional fluid resuscitation treatment)and the observation group(BMO 2UC)as the guide for fluid resuscitation treatment),with 30 patients in each group.The total fluid replacement volume,hemodynamic indicators,coagulation indicators and prognosis of patients in the two groups after 2 days of fluid resuscitation were compared.Results After 2 days of resuscitation,the total fluid intake of patients in the observation group was significantly lower than that of the conventional group,and the mean arterial pressure and blood pressure amplitude were significantly lower than that of the conventional group,with statistically significant differences between the two groups(P<0.05).After 2 days of resuscitation,thrombin time,plasma prothrombin time,activated partial thrombin time and other coagulation indexes of patients in both groups were significantly improved,and all coagulation indexes of patients in the observation group were significantly lower than those in the conventional group(P<0.05).After 2 weeks of treatment,the National Institutes of Health Stroke Scale(NIHSS)score for neurological deficits in the observation group was significantly lower than that in the conventional group,and the Glasgow Coma score in the observation group was significantly higher than that in the conventional group(P<0.05).Conclusion BMO 2UC has a significant effect on the treatment of patients with craniocerebral injury combined with shock,and can significantly improve the prognosis of patients.
作者
刘丽诗
嵇丹丹
罗亮
殷政
徐幸
LIU Li-shi;JI Dan-dan;LUO Liang;YIN Zheng;XU Xing(Department of Intensive Care Unit,Wuxi Second People′s Hospital,Wuxi 214000,China)
出处
《创伤与急危重病医学》
2020年第5期326-329,共4页
Trauma and Critical Care Medicine
基金
江苏省第十四批“六大人才高峰”高层次人才选拔培养资助方案(WSN-184)。
关键词
颅脑损伤
脑改良氧利用率
休克
液体复苏
预后
Craniocerebral injury
Cerebral improved oxygen utilization ratio
Shock
Fluid resuscitation
Prognosis
