创伤；失血性休克；治疗;高原_

高原不同人群创伤失血性休克的综合治疗

http://www.100md.com 《创伤外科杂志》 2006年第6期

创伤；失血性休克；治疗;高原,,创伤；失血性休克；治疗;高原,1一般资料,2统计项目,1坚持早期、适量、个体化液体复苏原则,2尽早输注浓缩红细胞、提高血液的

     摘要：目的探讨高原(海拔>3658m)不同人群创伤失血性休克患者综合治疗的特点。方法对高原世居藏族(A组, n=276)、移居高原汉族(B组，移居高原>3个月，n=189)和急进高原汉族(C组，进入高原1周以内，n=16)中度创伤失血性休克患者的救治过程进行回顾性分析。结果高原创伤失血性休克患者的综合治疗措施主要有：(1)早期适量个体化液体复苏；(2)尽早输注浓缩红细胞、提高血液的携氧能力；(3)减轻创伤应激、积极保护胃肠道功能、预防全身和局部感染的发生；(4)减轻全身的脂质过氧化损伤，积极调节机体的免疫状态;(5)改善休克后机体的代谢状态；(6)改善组织的缺氧状态、纠正酸中毒；(7)特别注意防治肺、脑水肿。结论 A、B、C组患者对综合治疗措施依赖性具有显著差异，依次为C组>B组>A组。

    关键词：创伤；失血性休克；治疗;高原

    Comprehensive therapies of traumatichemorrhagic shock in different cases at high altitude

    YIN Zuoming,LI Suzhi,LIN Xiulai,et al.

    (Center of War Wound and Trauma Care in Plateau( PLA),General Hospital of Tibet Military Area Command,Lasa 850003)

    Abstract: Objective To investigate the characteristics of comprehensive therapies of traumatichemorrhagic shock in different cases at high altitude (Lhasa,>3658m).Methods A retrospective study on the midrange traumatichemorrhagic shock at high altitude.It was divided into A group(tibet people,n=276) ,B group(Han people move to Lhasa above 3 months,n=189) and C group(Han people move to Lhasa in 7 days,n=16).Results The comprehensive therapies includes:(1)quantity sufficient and individuation fluid resuscitation in the early period of shock;(2)an earlier infusion RCC to raise the oxygen carrying capacity of blood;(3)lessening the stress reaction of trauma to protect the function of gastrointestinal tract,to prevent the infection of body and wound;(4)lessening the lipid peroxidation and regulate the immune state of the body;(5)improving the metabolic state of the body;(6)improving the hypoxia state to correct acidosis of the tissue,(7)prevention of pulmonary edema and brain edema.Conclusion The dependence of mutipletherapy was C group > B group > A group. ......

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