外科休克病人液体复苏终点评估

The endpoint of fluid therapy for surgical shock patients

外科休克病人液体治疗时如何做到既充分复苏又避免过度复苏,一直是困扰外科医师的临床问题。根据现有的循证医学证据,尚无指标能够全面、准确地反映病人真实的容量状态,且不能支持一种或一组指标作为休克特定的复苏终点。须连续、动态地评估治疗的反应性,在综合临床表现的基础上,采用多个不同指标相结合的方法,才能最接近病人的真实状态。

How to resuscitate sufficiently while avoidingoverload for surgical shock patients is a clinical issue thatperplexes the surgeon. According to the existing evidence,there is no index which could reflect the practical capacitystate of patients comprehensively and accurately, and couldnot support one or a set of indicators as shock specific recoverydestination. Continuously and dynamicly assessmentingresponse to treatment, basing on the comprehensive clinicalmanifestations, using the method of multiple differentindicator , could make it close to the practical state of thepatient.