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损伤控制性复苏：早期纠正凝血障碍 被引量：2

Damage control resuscitation： redress the coagulopathy at the early stage
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摘要 自从损伤控制性复苏的概念提出以来，临床工作中对于出现“死亡三联征”的严重创伤患者多采用它进行救治，以纠正低体温和酸中毒为中心。随着创伤外科学的不断发展，早期纠正凝血障碍在复苏过程中的关键作用渐渐浮出水面，该文将针对损伤控制性复苏中：（1）早期纠正凝血障碍的重要性；（2）纠正凝血障碍的恰当时机；（3）纠正凝血障碍的复苏方案，进行分析并提出相应的解决建议。 After the concept of damage control resuscitation is introduced, in the most severely injured casualties, when the lethal triad of hypothermia, acidosis, and coagulopathy are present, resuscitation practice for damage control usually focuses on rapid reversal of acidosis and prevention of hypothermia, while direct treatment of coagulopathy has been relatively neglected. Recent studies have brought back to light the importance of treating the coagulopathy of trauma at an earlier stage. This review focused on the importance and the right time of treating this disorder, analyzed the methods of addressing the early coagulopathy in damage control resuscitation and gave some advices.
作者 耿硕 刘连新
机构地区 哈尔滨医科大学附属第一临床医院普外科
出处 《国际外科学杂志》 2008年第10期687-690,共4页 International Journal of Surgery
关键词 损伤控制性复苏 凝血障碍 输血 液体复苏 创伤 damage control resuscitation coagulopathy transfusion fluid resuscitation trauma
分类号 R64 [医药卫生—外科学]
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参考文献19

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同被引文献29

  • 1任建安,黎介寿.损伤控制性复苏[J].中国实用外科杂志,2007,27(8):593-594. 被引量：54
  • 2R otondo MF, Schwab CW, McGonigal MD, et al. "Damage control": an approach for improved survival in exsanguinating penetrating abdominal injury. J Trauma, 1993, 35(3): 375-383.
  • 3Gawande A. Casualties of war-military care for the wounded from Iraq and Afghanistan. N Engl J Med, 2004, 351(24): 2471-2475.
  • 4Hess JR, Holeomb JB, Hoyt DB. Damage control resuscitation: the need for specific blood products to treat the coagulopathy of trauma. Transfusion, 2006, 46(5): 685686.
  • 5American College of Surgeons. Committee on Trauma. Advanced Trauma Life Support for Doctors. 7th ed. Chicago, IL, 2004.
  • 6Midwinter MJ, Woolley T. Resuscitation and coagulation in the severely injured trauma patient. Phil. Philos Trans R Soc Lond B Biol Sci, 2011, 366(1562): 192-203.
  • 7Theusinger OM, Spahn DR, Ganter MT. Transfusion in trauma: why and how should we change our current practice? Curr Opin Anaesthesiology, 2009, 22(2): 305-312.
  • 8Ho AM, Karmakar MK, Dion PW. Are we giving enough coagulation factors during major trauma resuscitation? Am J Surg, 2005, 190(3): 479-484.
  • 9Meng ZH, Wolberg AS, Monroe DM 3rd, et al. The effect of temperature and pH on the activity of factor VIIa: implications for the efficacy of high-dose factor VIIa in hypothermic and acidotic patients. J Trauma, 2003, 55(5) : 886-891.
  • 10Martini WZ, Cortez DS, Dubick MA, et al. Thromboelastography is better than PT, aPTT and activated cotting time in detecting clinically relevant clotting abnormalities after hypothermia, hemorrhagic shock and resuscitation in pigs. J Trauma, 2008, 65 (3): 535-543.

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国际外科学杂志
2008年 第10期

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