文档介绍：· 96· 创伤外科杂志 2006 年第 8 卷第 1 期 J Trauma Surg,2006,VoI. 8,No. 1
· 讲座·
文章编号:1009 - 4237(2006)01 - 0096 - 02
限制性液体复苏临床应用中几个应注意的问题
吴恒义,顾葆春
(广州军区广州总医院 ICU,广东广州 510010)
摘要: 针对日前正被大家认识和接受的限制性液体复苏的治疗方法,笔者重点强调以下几点:限制
性液体复苏应侧重于以心胸部和腹部为主的有活动性出血的休克病人,但对于严重颅脑外伤病人应慎用;
要注意不同致伤部位的差异和病人个体化差异,不要一概而论。尤其是对患有高血压的颅脑外伤病人,血
压不要调得太低,以免发生脑供血不足;平均动脉压(MAP)以调节在 80 ~ 90mm~g 为宜。在监控指标上仍
主张以血压、尿量、乳酸和硷基作为限制性液体复苏的评估和指导。限制性液体复苏的持续时间越短越好,
对有活动性出血的休克病人,手术止血越早越好。
关键词:液体复苏;休克
中图分类号:R 641. 059. 7 文献标识码:A
Attention on clinical application of hypotension resuscitation
WU Heng-yi,GU Bao-chun
(Guangzhou GeneraI ~ospitaI of mand of PLA,Guangzhou 510010,China)
Abstract: Limited resuscitation(hypotension resuscitation)has been accepted as a strategy to treat uncon-
troIIed hemorrhagic shock. It is mended mainIy to the patients with uncontroIIed bIeeding in chest and abdo-
men. For the head trauma patients,the strategy shouId be appIied cautiousIy. The different kinds of injury shouId
be considered carefuIIy,and treatment shouId be individuaIiyed during hemorrhagic shock treatment. For head trau-
matic patients with hypertension,the mean arteriaI pressure( MAP)shouId be maintained between 80-90mm~g.
BIood pressure,urine voIume,Iactate IeveI and base deficit are criteria to guide the strategy. For uncontroIIed bIeed-
ing,shorter time of Iimited resuscitation and earIier operation ar