损伤控制性复苏及其对野战输血研究的启示

Damage control resuscitation and its implications for battlefield transfusion

战伤引起的急性凝血病是导致重度失血伤员死亡的关键因素。美军在2006年提出了以预防急性凝血病为前提的战伤休克救治方案,即损伤控制性复苏方案,大大降低了重度失血伤员的死亡率。本文综述了凝血病对战伤救治效率的影响、凝血病产生的机制、损伤控制性复苏方案及其战伤救治中的应用等,并讨论了损伤复苏方案对我军野战输血研究的启示。

Acute coagulopathy induced by combat trauma is a main cause of death for severe hemorrhagic patients. Damage control resuscitation （DCR） which focused on coagulopathy prevention in the early stage was proposed by US Army Institute of Surgical Research in 2006. This resuscitation strategy could dramatically reduce the mortality of severe hemor- rhagic patients. The impact of coagulopathy on combat trauma treatment, the mechanism of coagulopathy induced by hemor- rhage and the application of DCR in combat trauma treatments are reviewed. The implication of DCR for military transfusion is also discussed.