烧伤休克期补液

Retrospection and recent advances in fluid resuscitation during burn shock stage

众所周知，严重烧伤患者伤后48h内为急性渗出期，由于体液丢失兼有血细胞破坏，导致血容量减少和组织细胞缺氧，进而诱发休克。近50年来全国烧伤专业工作者围绕烧伤休克做了大量临床与实验研究，取得了卓有成效的进展，使休克的发生率和病死率明显下降，但绝不能据此就认为休克问题已基本解决，事实上有关烧伤休克的发生机制远未完全阐明，防治措施仍待进一步改进。

To retrospect the development of fluid resuscitation for burn shock and to look to the future. The main achievements in burn care in the past fifty years and existing problems are summarized , and the appropriate regime of fluid resuscitation for burn shock is suggested. Numerous achievements in burn care have been made, including the estimation of burn area, fluid replenishment formula, delayed resuscitation, fluid resuscitation for burn shock complicated by inhalation injury, covert compensatory shock and research on mechanism of burn shock etc. We had established and improved fluid resuscitation formula, and we had made clear how to properly resuscitate burn shock. However how to tide over the patient form burn shock smoothly had not yet reached a consensus. Effective treatment to alleviate hypoxic injuries as a result of severe shock had not been properly defined. Although significant achievements in fluid resuscitation for burn shock have been made, there is still a long way to go to attain a perfect regime. Therefore it is still utterly necessary to carry on in-depth research on this problem both in the laboratory and bedside.