Application effect of restrictive fluid resuscitation in emergency treatment of obstetric massive hemorrhage
CHEN Ping1 XIAO Xiang2 ZHANG Jie1 YU Yan1
1. Department of Obstetrics, Shenzhen Bao′an Maternal and Child Health Hospital, Guangdong Province, Shenzhen 518000, China;
2. MICU, Shenzhen Bao′an Maternal and Child Health Hospital, Guangdong Province, Shenzhen 518000, China
Abstract：Objective To explore the application effect of restrictive fluid resuscitation in the emergency treatment of obstetric hemorrhage. Methods From May 2018 to December 2020, 200 patients with obstetric hemorrhage admitted to Shenzhen Bao′an District Maternal and Child Health Hospital were selected as the research objects, and divided into observation group (100 cases) and control group (100 cases) by random lottery method. The observation group was treated with restrictive fluid resuscitation, and the control group was treated with traditional infusion resuscitation. The fluid input volume, bleeding volume and blood transfusion volume, hemodynamic indicators, coagulation function indicators, and treatment effect were compared between the two groups. Results After 2 hours of treatment, the amount of fluid input, blood loss and blood transfusion in the observation group were less than those in the control group, and the differences were statistically significant (P＜0.05). There were no statistically significant differences in mean arterial pressure (MAP), central venous pressure (CVP), hematocrit (HCT), and heart rate (HR) between the two groups before treatment (P>0.05). After treatment, MAP, CVP and HCT of the two groups were higher than those before treatment,and HR was lower than that before treatment, and MAP, CVP and HCT of observation group were higher than those of control group, and HR was lower than that of control group, the differences were statistically significant (P＜0.05). There were no significant differences in prothrombin time (PT), partial thrombin time (APTT), thrombin time (TT) and fibrinogen (FIB) between the two groups before treatment (P>0.05). After treatment, PT, APTT and TT in the two groups were lower than those before treatment, while FIB was higher than that before treatment, and PT, APTT and TT in the observation group were lower than those of control group, while FIB was higher than that of control group, the differences were statistically significant (P＜0.05). The total effective rate of observation group was higher than that of control group,the difference was statistically significant (P＜0.05). Conclusion Restricted fluid resuscitation is very effective in emergency treatment of obstetric massive hemorrhage, which can effectively improve fluid input, blood loss and transfusion volume, hemodynamic indexes, coagulation function indexes and therapeutic effect.
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