Effects Of Different Fluid Restriction Resuscitation On Coagulation Function And Thromboelasticdiagram In Patients With Hemorrhagic Shock

Objective: To explore the rescue effect of different restrictive fluid(sodium acetate ringer’s solution and sodium lactate ringer’s solution)resuscitation on traumatic hemorrhagic shock patients(THS)and the effects on coagulation function(prothrombin time,activated partial thrombin time)and thromboelastic diagram(K,R,MA,etc.).In order to choose a more ideal recovery fluid.Methods: Forty patients with hemorrhagic shock admitted to the emergency surgery department of the First Affiliated Hospital of Bengbu Medical College from January2017 to June 2019 were selected as the research objects.All patients were randomly divided into sodium acetate Ringer’s solution group and sodium lactate Ringer.20 cases in each group,namely AR group and LR group.Resuscitation fluid in the AR group was sodium acetate Ringer’s solution,and resuscitation fluid in the LR group was sodium lactate Ringer’s solution.Resuscitation methods were restricted fluid resuscitation.Peripheral venous blood samples were taken before resuscitation and 1 hour after resuscitation.The prothrombin time,activated partial thromboplastin time,Thrombin time and thromboelastography related parameters(K,R,MA.)in the two groups of patients were compared.To observe the effects of two fluids on coagulation function in patients with hemorrhagic shock.Results: After the occurrence of shock and before restrictive fluid resuscitation,the general condition of the AR group and the LR group was not statistically significant(P> 0.05);within the group comparison: there were no statistically significant differences in APTT and PT in the AR group before and after resuscitation(P> 0.05),and the differences in APTT and PT in the LR group were statistically significant(P<0.05);the differences in TT values before and after resuscitation in the two groups were statistically significant(P <0.05).There was a statistically significant difference in the R value of the thromboelastogram in the LR group before and after resuscitation(P <0.05),and there was no significant difference in the MA value of the thromboelastogram in the two groups before and after resuscitation(P> 0.05).Comparison between groups: There was no significant difference in blood coagulation function and thromboelastography related indexes between the two groups before resuscitation(P> 0.05),and the difference in TT value of coagulation function between the two groups was statistically significant at one hour after resuscitation(P< 0.05);the K value of the thromboelastography of the two groups was statistically significant(P <0.05),and the R value and MA value of the thromboelastography of the two groups were not statistically significant(P> 0.05).Conclusion: Compared with sodium lactate Ringer’s liquid,restrictive fluid resuscitation in patients with hemorrhagic shock selects sodium acetate Ringer’solution as the resuscitation fluid,which has a smaller effect on the coagulatio-n function of patients with hemorrhagic shock,and can be more effectively prevented or(and)reduced Risk of rebleeding in patients with hemorrhagic shock.