Akaraborworn Osaree
Division of Trauma Surgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
Chin J Traumatol. 2014 Apr 1;17(2):108-11.
Hemorrhage is the second most common cause of death among trauma patients and almost half of the deaths occur within 24 hours after arrival. Damage control resuscitation is a new paradigm for patients with massive bleeding. It consists of permissive hypotension, hemostatic resuscitation and transfusion strategies, and damage control surgery. Permissive hypotension seems to have better results before the bleeding is controlled. The strategy of fluid resuscitation is minimizing crystalloid infusion and increasing early transfusion with a high ratio of fresh frozen plasma to packed red cells. Damage control surgery is done when the patient's condition is unfit for definitive surgery. Hemorrhage and contamination control with temporary abdominal closure is performed before transferring the patients to intensive care unit and the operating room for a permanent laparotomy.
出血是创伤患者中第二常见的死亡原因，几乎一半的死亡发生在入院后24小时内。损伤控制复苏是针对大出血患者的一种新范式。它包括允许性低血压、止血复苏和输血策略以及损伤控制手术。在出血得到控制之前，允许性低血压似乎有更好的效果。液体复苏策略是尽量减少晶体液输注，并增加早期输血，使新鲜冰冻血浆与浓缩红细胞的比例更高。当患者的病情不适合进行确定性手术时，进行损伤控制手术。在将患者转移到重症监护病房和手术室进行永久性剖腹手术之前，先进行临时腹部闭合以控制出血和污染。
