失血性休克复苏治疗进展与评价

The new resuscitation strategy for hemorrhagic shock

传统的复苏方法和目标对于出血尚未被有效控制的失血性休克可能是有害的。存在的证据支持对该类伤员采取低度干预的策略,直到进行决定性手术。对复苏液体的选择仍然存在争议,晶体液和胶体液联合使用看来更合理,并能够被多数医生所接受。应该注意,新的复苏策略不适用于合并某些类型创伤的休克,如合并创伤性脑损伤的休克。另外,新复苏策略对预后的长期影响也需要进一步研究。

For uncontrolled hemorrhagic shock the traditional method and target of resuscitation may be harmful. The existing data supported a strategy of less aggressive interventions to those shock with uncontrolled hemorrhage until a decisive surgery begin. The choice of liquor for resuscitation remains in controversy. A combined application of crystalloid and colloid liquor seems to be reasonable and may be accepted by most physicians. It should be noted that the new resuscitation strategy may not be suitable to some kinds of trauma, such as traumatic brain injury, and its long-term effects on to the prognosis should be further evaluated.