《欧洲创伤性严重出血和凝血病管理指南(第6版)》解读

Introduction to the European Guideline on Management of Major Bleeding and Coagulopathy Following Trauma(sixth edition)

近期修订的《欧洲创伤性严重出血和凝血病管理指南(第6版)》,按照创伤患者出血管理的关键决策步骤和时间节点,以成组的方式提供了初始复苏和防止进一步出血,出血评估和监测,组织氧合、容量、液体和体温管理,快速控制出血,出血和凝血病的初始管理,后续目标导向凝血管理,使用抗血栓药品患者的管理,血栓预防以及指南实施与质量控制方面共39条临床推荐。我们对新版《指南》的推荐意见及其主要变化、血液复苏相关推荐的证据总结和推荐理由予以介绍,补充了新近发表的部分临床研究证据,以期为我国创伤出血患者血液复苏指南或方案的编制和教育培训提供重要的参考信息。

In the European Guideline on Management of Major Bleeding and Coagulopathy Following Trauma updated recently,there are 39 clinical practice recommendations that follow an approximate temporal path for management of the bleeding trauma patient,with recommendations grouped behind key decision points,including initial resuscitation and prevention of further bleeding,diagnosis and monitoring of bleeding,rapid control of bleeding,initial management of bleeding and coagulopathy,further goal-directed coagulation management,management of antithrombotic agents,thromboprophylaxis,guideline implementation and quality control,as welll as the management of tissue oxygenation,volume,fluids and temperature.In this paper,we introduce the recommendations and rationale of the guideline and add some newly published clinical study evidence.These information would be very helpful to the development and training of the guidelines or protocols for the management of the trauma patient with major haemorrhage and coagulopathy in China.