严重创伤患者的复苏和凝血。
Resuscitation and coagulation in the severely injured trauma patient.
机构信息
Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK.
出版信息
Philos Trans R Soc Lond B Biol Sci. 2011 Jan 27;366(1562):192-203. doi: 10.1098/rstb.2010.0220.
Abstract
Developments in the resuscitation of the severely injured trauma patient in the last decade have been through the increased understanding of the early pathophysiological consequences of injury together with some observations and experiences of recent casualties of conflict. In particular, the recognition of early derangements of haemostasis with hypocoagulopathy being associated with increased mortality and morbidity and the prime importance of tissue hypoperfusion as a central driver to this process in this population of patients has led to new resuscitation strategies. These strategies have focused on haemostatic resuscitation and the development of the ideas of damage control resuscitation and damage control surgery continuum. This in turn has led to a requirement to be able to more closely monitor the physiological status, of major trauma patients, including their coagulation status, and react in an anticipatory fashion.
摘要
在过去十年中，严重创伤患者的复苏发展是通过对损伤早期病理生理学后果的深入了解以及对最近冲突中伤员的一些观察和经验而取得的。特别是，人们认识到早期止血功能紊乱伴发低凝状态与死亡率和发病率增加有关，组织低灌注作为该患者人群中这一过程的主要驱动因素具有重要意义，由此产生了新的复苏策略。这些策略侧重于止血复苏，以及损伤控制性复苏和损伤控制性手术连续性理念的发展。这反过来又要求能够更密切地监测包括凝血状态在内的重大创伤患者的生理状态，并以预期的方式做出反应。
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