Comparative observation of the clinical effect of immediate recovery of fluid resuscitation in traumatic shock and delayed resuscitation

Abstract

Objective To investigate the clinical value of immediate fluid resuscitation and delayed resuscitation in patients with traumatic shock. Methods The patients with traumatic shock treated in the Critical Care Medicine Department of People′s Hospital of Wenjiang District from March 2014 to March 2017 were selected.According to the number of admission cases, one hundred and twenty patients with traumatic shock were randomly divided into two groups, 60 cases in each group.The control group was given early immediate fluid resuscitation, the observation group was given delayed resuscitation, and the blood coagulation and blood routine indexes of the two groups were compared before and after the fluid resuscitation in the two groups, and the amount of fluid rehydration and the fatality rate in the two groups of patients with 1 h shock were observed, and the incidence rate of acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndrome (MODS) were compared. Results After treatment, the blood clotting and blood routine indexes of the two groups were improved (P<0.05), of which the thromboplastin time (PT) ((11.04±1.17) s), activated partial thromboplastin time (APTT) ((28.12±5.93)s)in the observation group in the observation group were lower than those of the control group( (15.12±1.26) s, (36.17±9.05) s) (t=-15.37, -9.81, P<0.05), platelet countPLT) ((146.92±16.85)×109/L) was higher than that of the control group ((114.18±10.69)×109/L )(t=-9.77, P<0.05), and the blood routine hemoglobin (Hb) ((112.21±9.46) g/L), and the base surplus(BE)((-5.30±2.45) mmol/L )were all higher than those of the control group ((92.95±11.20) g/L, (-8.27±3.53) mmol/L ) (t=-11.46, -8.99, P<0.05), blood lactic acid (BL) ((2.79±1.12) mmol/L ) was lower than that of the control group ((3.54±1.37) mmol/L) (t=-8.99, P<0.05). The volume of 1 h infusion of shock in the observation group ((569.96±187.34) ml ) was lower than that of the control group ((1 957.35±204.14) ml) (t=8.725, P<0.05). The incidence of ARDS (3.33% (2/60)), MOD(3.33% (2/60)) and fatality(1.67%(1/60))were lower than those of the control group(8.33%(5/60), 6.67%(4/60), 6.67%(4/60)(χ2=2.725, 3.214, 2.985, P<0.05). Conclusion The early stage of traumatic shock delayed fluid resuscitation is conducive to the protection of the blood coagulation function of patients, to improve blood indicators, to reduce the amount of 1 h infusion and to reduce the incidence of ARDS and MODS. Key words: Traumatic shock; Immediate fluid resuscitation; Delayed resuscitation; Clinical value