摘要目的 探讨大容量复苏对早期严重创伤性休克患者血流动力学和氧输送的影响.方法 监测24例严重腹部创伤患者不同容量复苏时的血流动力学和氧代谢指标.结果 容量复苏收缩压从80～90mm Hg(1 mm Hg=0.133 kPa)上升到100～120 mm Hg时,平均复苏容量分别为(2286±521)ml(1 h)和(3486±758)ml(2 h).心脏指数(CI)从(2.0±0.5)L/(min·m2)上升为(3.2±0.6)L/(min·m2)(P<0.05),体循环阻力指数(SVRI)从(1857.6±750.2)dyn·s/(cm5·m2)上升为(3741.5±862.1)dyn·s/(cm5·m2)(P<0.05),与之相对应,氧输送指数(DO2)从(301.1±74.1)ml/(min·m2)升为(554.1±80.0)ml/(min·m2)(P<0.05),氧耗指数(VO2)为(99.7±51.4)ml/(min·m2)升为(147.2±60.1)mL/(min·m2)(P<0.05),氧摄取指数(O2ext)为(33.1±9.1)%下降至(26.6±8.0)%(P<0.05).结论 在急诊抢救中,早期大容量复苏能改善血流动力学和氧代谢.

abstractsObjective To observe the effect of fluid resuscitation on hemodynamies and oxygen in severe trauma patients. Methods Parameters of hemodynamic and oxygen metabolism in different fluid volume resuscita-tion in 24 severe trauma patients who were injured on abdominal were measured. Results By fluid resuscitation, as the systolic blood pressure was raised from 80～90 mm Hg(1 mm Hg=0.133 kPa) to 100～120 mm Hg,cardiac in-dex rose from (2.0±0.5 ) L/(min·m2) to (3.2±0.6) L/(min·m2) (P<0.05), systemic vascular resistance index rose from (1857.6±750.2) dyn·s/(cm5·m2) to (3741.5±862.1) dyn·s,/(cm5·m2) significantly (P<0.05). Meanwhile, oxygen delivery index rose from (301.1±74.1) ml/(min·m2) to (554.1±80.0) mL/(min·m2) (P<0.05), and oxygen consumption index also rose (99.7±51.4) mL/( min·m2) to (147.2± 60.1) mL/(min·m2) remarkably (P<0.05), the rate of oxygen expenditure decreased from (33.1±9.1) % to (26.6±8.0) % significantly (P<0.05). Conclusion Large volume resuscitation maybe benefit to the improve-ment of hemodynamics and oxygen metabolism in the emergency resuscitation.