严重创伤损害控制复苏的研究进展

Progress in damage control resuscitation of severe trauma

严重创伤后导致的“致死三联征”是患者死亡主要原因之一,如何降低患者死亡率、提高生存率、减少并发症发生率是急诊科和创伤科医务工作者面临的主要问题。对于严重创伤患者的早期救治,特别是创伤后大出血的救治,损害控制复苏技术的应用尤为重要。其概念最先源于战场救援,经过近二十年的临床应用研究表明,损害控制复苏技术极大地降低了严重创伤后的并发症和死亡率。文章就损害控制复苏技术的适应症,重点复苏措施、辅助复苏措施、复苏终点的判断及复苏后处理的研究进展进行综述。

The"lethal triplet"caused by severe trauma is the main cause of death of patients.How todecrease the death rate,improve the survival rate and reduce the incidence of complications is the main problem faced by medical workers in emergency and trauma departments.The application of damage control resuscitation technology is particularly important in primary treatment of severe trauma patients,especially in the treatment of post-traumatic hemorrhage.The concept first originated from battlefield rescue,and after nearly two decades of clinical application research,it has been shown that damage control resuscitation technology significantly reduces post-traumatic complications and mortality.This paper reviews the indications of damage control resuscitation technology,the key resuscitation measures,auxiliary resuscitation measures,the judgment of the end point of resuscitation and the research progress of post-resuscitation treatment.