国际麻醉学与复苏杂志   2017, Issue (7): 8-8
    
损伤控制性复苏用于失血性休克救治的研究进展
杜薇, 曹慧娟, 张铁铮1()
1.沈阳军区总医院
Progress of damage control resuscitation in the treatment of hemorrhagic shock
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摘要:

背景 失血性休克(hemorrhagic shock, HS)是导致人类死亡和致残的重要原因,与患者转归密切相关,目前尚缺乏理想的复苏方案。 目的 综述损伤控制性复苏(damage control resuscitation, DCR)研究进展。 内容 DCR是较新的整合性复苏策略,已被广泛应用于创伤急救、心脏外科、妇产科等多个手术领域。由于凝血机制的破坏,HS患者常伴有创伤性凝血病、低体温和酸中毒。DCR推荐对HS患者进行允许性低压复苏、止血复苏和损伤控制性手术的处理。DCR不仅可以提高复苏效果,还能减少休克相关并发症。 趋向 DCR在HS处理中有良好应用前景,然而尚需进一步研究使其完善。

关键词: 失血性休克; 损伤控制性液体复苏; 止血复苏
Abstract:

Background Hemorrhagic shock(HS) is one of the major causes of death and disability. Clinical investigation demonstrates that the prognosis of HS patients seems correlated with the strategies applied for resuscitation. However, treatments that can effectively improve the recovery of HS are still absent. Objective To review the treatment of HS with damage control resuscitation(DCR). Content DCR is a new integrated strategy, and has been used in a wide variety of surgeries, including trauma emergency treatment, cardiac surgery, obstetric surgery, etc. HS is commonly seen in patients with trauma-associated coagulopathy, hypothermia, and acidosis, because of the disturbed blood coagulation. DCR recommends permissive hypotension, hemostatic resuscitation, and damage control surgery in the treatment of HS. It not only improves the recovery of HS, but also helps reduce risk of shock-related complications. Trend DCR is a potential treatment for HS, while further investigations are required to optimize the procedures.

Key words: Hemorrhagic shock; Damage control resuscitation; Hemostatic resuscitation