失血性休克液体复苏的进展

The Fluid Resuscitation Progress on Hemorrhagic Shock

目的:探讨和总结近年来对失血性休克液体复苏的研究进展。方法:对近20年来国内外相关文献和综述的查阅和总结。结果:失血性休克在控制出血后应用高渗盐水复苏可降低出血的危险,提高复苏的效果。对出血未控制的失血性休克患者,应早期采用控制性复苏以保证重要脏器的基本灌注,并尽快止血,但复苏液温度的选择仍值得探讨。在判断复苏终点时组织灌注和氧代谢指标对评估休克及判断预后具有重要意义。结论:积极控制出血、迅速扩容、准确判断复苏终点是失血性休克复苏成功的关键。

Objective：To explore and summarize the new progress in hemorrhagic shock fluid resuscitation. Methods： Inquiring and summarizing domestic and international literatures about hemorrhagic shock fluid resus- citation in recent 20 years. Results：in the hemorrhagic shock the resuscitation of hypertonic saline after control- ling- hemorrhage can reduce the risk of bleeding- and improve the effectiveness of resuscitation. For uncontrolled bleeding patients with hemorrhagic shock we should use controlled fluid resuscitation early to ensure the basic in- fusion of important organs and stop bleeding as soon as possible. The temperature of the recovery is still worth exploring. The organization reper[usion and indicators oxygen metabolism is of great significance in the assess- ment of shock and prognosis. Conclusion： the key to success of hemorrhagic shock fluid resuscitation is control bleeding positive, expansion rapid and judge the resuscitation end accurate.