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产科损伤控制性复苏。

Damage-control resuscitation in obstetrics.

机构信息

High Complexity Obstetric Unit, Department of Obstetrics and Gynecology, Fundación Valle del Lili, Cali, Colombia.

Faculty of Health Sciences, ICESI University, Cali, Colombia.

出版信息

J Matern Fetal Neonatal Med. 2022 Feb;35(4):785-798. doi: 10.1080/14767058.2020.1730800. Epub 2020 Feb 26.

Abstract

Severe obstetric hemorrhage is a catastrophic event and represents the main cause of maternal morbidity and mortality worldwide. The elevated mortality rate due to hemorrhage is associated with metabolic complications and organ hypoperfusion that may trigger a state of irreversible coagulopathy. Thus, the use of conventional measures to control bleeding frequently generates a vicious cycle in which the patient continues bleeding (prolonging surgical times). Damage-control surgery has proven to be feasible and effective in the context of obstetric hemorrhage. It combines surgical and resuscitative measures that generate successful results in the control of refractory bleeding, ultimately decreasing mortality in patients being in critical condition.

摘要

严重产科出血是一种灾难性事件,是全世界产妇发病率和死亡率的主要原因。出血导致的高死亡率与代谢并发症和器官低灌注有关,这可能引发不可逆转的凝血功能障碍。因此,常规止血措施的使用往往会导致恶性循环,使患者持续出血(延长手术时间)。损伤控制性手术已被证明在产科出血的情况下是可行和有效的。它结合了手术和复苏措施,在控制难治性出血方面取得了成功的结果,最终降低了危急患者的死亡率。

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