损伤控制复苏在急诊的运用
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摘要
<正>随着现代社会发展和科学的进步,创伤已然成为一个公共卫生保健问题,因道路交通事故造成的严重创伤愈加增多。根据2017年国家安全生产监督管理总局国际交流合作中心等发布的"道路交通运输安全发展报告",2015年我国道路交通事故起数为187781起,万车死亡率为2.08%,连续十年高居世界主要部分国家第一~([1])。国外有学者~([2])统计56%～87%的创伤患者由于大出血没能获得及时有效救治而死于院前,其中80%～90%因出血致死的创伤患者院前如果能
Severe trauma is a public health problem that threatens the safety of human life in peacetime.Continuous improvement of the survival rate of patients with severe trauma is one of the important goals of emergency trauma doctors.Damage control resuscitation(DCR)is a strategy for rapid recovery of homeostasis in patients with hemorrhagic shock resuscitation.The appropriate use of DCR technology by emergency trauma practitioners can reduce mortality in trauma patients.
Severe trauma is a public health problem that threatens the safety of human life in peacetime.Continuous improvement of the survival rate of patients with severe trauma is one of the important goals of emergency trauma doctors.Damage control resuscitation(DCR)is a strategy for rapid recovery of homeostasis in patients with hemorrhagic shock resuscitation.The appropriate use of DCR technology by emergency trauma practitioners can reduce mortality in trauma patients.
引文
[1] 正国,尹志勇,张良,等.道路交通运输安全发展报告(2017)解读——德国和欧盟提高交通安全的主要措施[J].中华创伤杂志,2018,34(10):865-868.
[2] Chaudery M,Clark J,Wilson MH,et al.traumatic intra-abdominal hemorrhage contol:has current technology tipped the balance toward a role for prehospital intervention?[J].J Trauma Acute Care Surg,2015,78(1):153-163.
[3] Huber-Lang M,Lambris JD,Ward PA.Innate immune responses to trauma[J].Nat Immunol,2018,19(4):327-341.
[4] Bortolotti P,Faure E,Kipnis E.Inflammasomes in tissue Damages and Immune Disorders After Trauma[J].Front Immunol,2018,16(9):1900.
[5] Sauaia A,Moore FA,Moore EE.Postinjury inflammation and organ dysfunction[J].Crit Care Clin,2017,33(1):167-191.
[6] Rotondo MF,Schwab CW,McGonigal MD,et al.‘Damage control’:an approach for inproved survival in Exsanguinating penetrating abdominal injury[J].J Trauma,1993,35(3):375-382.
[7] Hess JR,Holcomb JB,Hoyt DB.Damage control resuscitation:the need for specific blood products to treat the coagulopathy of trauma[J].Transfusion,2006,46(5):685-686.
[8] Camazine MN,Hemmila MR,Leonard JC,et al.Massive transfusion policies at trauma centers participating in the American College of Surgeons Trauma Quality Improvement Program[J].J Trauma Acute Care Surg,2015,78(6 Suppl 1):S48-53.
[9] Moore EE.Thomas G.orr Memorial Lecture.Staged laparotomy for the hypothermia,acidosis,and coagulopathy syndrome[J].Am J Surg,1996,172(5):405-10.
[10] Eastridge BJ,Mabry RL,Seguin P,et al.Death on the battlefield(2001-2011):implications for the future of combat casualty care[J].J Trauma Acute Care Surg,2012,73(Suppl 5):S431-437.
[11] Maegele M,Lefering R,Yucel N,et al.Early coagulopathy in multiple injury:an analysis from the German Trauma Registry on 8724 patients[J]Injury,2007,38(3):298-304.
[12] Rossaint R,Bouillon B,Cerny V,et al.The European guideline on management of major bleeding and coagulopathy following trauma;fourth edition[J].Crit Care,2016,20:100.
[13] Glen J,Constanti M,Brohi K,Guideline Development Group.Assessment and initial management of major trauma:summary of NICE guidance[J].BMJ,2016,353:i3051.
[14] Carney N,Totten AM,O'Reilly C,et al.Guidelines for the management of severe traumatic brain injury,fourth edition[J].Neurosurgery,2017,80(1):6-15.
[15] Hu Y,Wu Y,Tian K,et al.Identification of ideal resuscitation pressure with concurrent traumatic brain injury in a rat model of hemorrhagic shock[J].J Surg Res,2015,195(1):284-293.
[16] Vrettos T,Poimenidi E,Athanasopoulos P,et al.The effect of permissive hypotension in combined traumatic brain injury and blunt abdominal trauma:an experimental study in swines[J].Eur Rev for Med Pharmacological Sci,2016,20(4):620-630.
[17] Wang HE,Callaway CW,Peitzman AB,et al.Admssion hypothermia and outcome after major trauma[J].Crit Care Med,2005,33(6):1296-1301.
[18] Beekley AC,Sebesta JA,Blackbourne LH,et al.Pre-hospital tourniquet use in operation Iraqi freedom:effect on hemorrhage control and outcomes[J].J Trauma,2008,64(2 Suppl):S28-37.
[19] Kirkman E,Watts S,Hodgetts T,et al.A proactive approach to the coagulopathy of trauma:the rational and guidelines for treatment[J].J R Army Med Corps,2007,153(4):302-306.
[20] Boffard KD,Riou B,Choong PI,et al.Recombinant factor VIIa as adjunctive therapy for bleeding control in severely injured trauma patients:two parallel randomised,placebo-controlled,double-blind clinical trials[J].J Trauma,2005,59(1):8-15.
[21] CRASH-2 trial collaborators,Shakur H,Roberts I,et al.Effects of tranexamic acid on death,vascular occlusive events,and blood transfusion in trauma patients with significant haemorrhage(CRASH-2):a randomized,placetrialbo-controlled trial[J].Lancet,2010,376(9734):23-32.
[22] CRASH-2 collaborators,Roberts I,Skakur H,et al.The importance of early treatment with tranexamic acid in bleeding trauma patients:an exploratory analysis of the CRASH-2 randomised controlled trial[J].Lancet,2011,26,377(9771):1096-1101.
[23] Borgman MA,Spinella PC,Perkins JG,et al.The ratio of blood products transfused affects mortality in patients receiving massive transfusions at a combat support hospital[J].J Trauma,2007,63(4):805-813.
[24] Sanais S,Mahmoodpoor A,Hamishekar H,et al.Association Between Disease Severity and Calcium Concentration in Critically Ill Patients Admitted to Intensive Care Unit[J].Anesth Pain Med,2018,8(1):e57583.
[25] Noel P,Cashen S,Patel B.Trauma-induced coagulopathy:from biology to therapy[J].Semin Hematol,2013,50(3):259-269.
[26] Jaber S,Paugam C,Futier E,et al.Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit(BICAR-ICU):a multicentre,open-label,randomised controlled,phase 3 trial[J].Lancet,2018,392(10141):31-40.
[2] Chaudery M,Clark J,Wilson MH,et al.traumatic intra-abdominal hemorrhage contol:has current technology tipped the balance toward a role for prehospital intervention?[J].J Trauma Acute Care Surg,2015,78(1):153-163.
[3] Huber-Lang M,Lambris JD,Ward PA.Innate immune responses to trauma[J].Nat Immunol,2018,19(4):327-341.
[4] Bortolotti P,Faure E,Kipnis E.Inflammasomes in tissue Damages and Immune Disorders After Trauma[J].Front Immunol,2018,16(9):1900.
[5] Sauaia A,Moore FA,Moore EE.Postinjury inflammation and organ dysfunction[J].Crit Care Clin,2017,33(1):167-191.
[6] Rotondo MF,Schwab CW,McGonigal MD,et al.‘Damage control’:an approach for inproved survival in Exsanguinating penetrating abdominal injury[J].J Trauma,1993,35(3):375-382.
[7] Hess JR,Holcomb JB,Hoyt DB.Damage control resuscitation:the need for specific blood products to treat the coagulopathy of trauma[J].Transfusion,2006,46(5):685-686.
[8] Camazine MN,Hemmila MR,Leonard JC,et al.Massive transfusion policies at trauma centers participating in the American College of Surgeons Trauma Quality Improvement Program[J].J Trauma Acute Care Surg,2015,78(6 Suppl 1):S48-53.
[9] Moore EE.Thomas G.orr Memorial Lecture.Staged laparotomy for the hypothermia,acidosis,and coagulopathy syndrome[J].Am J Surg,1996,172(5):405-10.
[10] Eastridge BJ,Mabry RL,Seguin P,et al.Death on the battlefield(2001-2011):implications for the future of combat casualty care[J].J Trauma Acute Care Surg,2012,73(Suppl 5):S431-437.
[11] Maegele M,Lefering R,Yucel N,et al.Early coagulopathy in multiple injury:an analysis from the German Trauma Registry on 8724 patients[J]Injury,2007,38(3):298-304.
[12] Rossaint R,Bouillon B,Cerny V,et al.The European guideline on management of major bleeding and coagulopathy following trauma;fourth edition[J].Crit Care,2016,20:100.
[13] Glen J,Constanti M,Brohi K,Guideline Development Group.Assessment and initial management of major trauma:summary of NICE guidance[J].BMJ,2016,353:i3051.
[14] Carney N,Totten AM,O'Reilly C,et al.Guidelines for the management of severe traumatic brain injury,fourth edition[J].Neurosurgery,2017,80(1):6-15.
[15] Hu Y,Wu Y,Tian K,et al.Identification of ideal resuscitation pressure with concurrent traumatic brain injury in a rat model of hemorrhagic shock[J].J Surg Res,2015,195(1):284-293.
[16] Vrettos T,Poimenidi E,Athanasopoulos P,et al.The effect of permissive hypotension in combined traumatic brain injury and blunt abdominal trauma:an experimental study in swines[J].Eur Rev for Med Pharmacological Sci,2016,20(4):620-630.
[17] Wang HE,Callaway CW,Peitzman AB,et al.Admssion hypothermia and outcome after major trauma[J].Crit Care Med,2005,33(6):1296-1301.
[18] Beekley AC,Sebesta JA,Blackbourne LH,et al.Pre-hospital tourniquet use in operation Iraqi freedom:effect on hemorrhage control and outcomes[J].J Trauma,2008,64(2 Suppl):S28-37.
[19] Kirkman E,Watts S,Hodgetts T,et al.A proactive approach to the coagulopathy of trauma:the rational and guidelines for treatment[J].J R Army Med Corps,2007,153(4):302-306.
[20] Boffard KD,Riou B,Choong PI,et al.Recombinant factor VIIa as adjunctive therapy for bleeding control in severely injured trauma patients:two parallel randomised,placebo-controlled,double-blind clinical trials[J].J Trauma,2005,59(1):8-15.
[21] CRASH-2 trial collaborators,Shakur H,Roberts I,et al.Effects of tranexamic acid on death,vascular occlusive events,and blood transfusion in trauma patients with significant haemorrhage(CRASH-2):a randomized,placetrialbo-controlled trial[J].Lancet,2010,376(9734):23-32.
[22] CRASH-2 collaborators,Roberts I,Skakur H,et al.The importance of early treatment with tranexamic acid in bleeding trauma patients:an exploratory analysis of the CRASH-2 randomised controlled trial[J].Lancet,2011,26,377(9771):1096-1101.
[23] Borgman MA,Spinella PC,Perkins JG,et al.The ratio of blood products transfused affects mortality in patients receiving massive transfusions at a combat support hospital[J].J Trauma,2007,63(4):805-813.
[24] Sanais S,Mahmoodpoor A,Hamishekar H,et al.Association Between Disease Severity and Calcium Concentration in Critically Ill Patients Admitted to Intensive Care Unit[J].Anesth Pain Med,2018,8(1):e57583.
[25] Noel P,Cashen S,Patel B.Trauma-induced coagulopathy:from biology to therapy[J].Semin Hematol,2013,50(3):259-269.
[26] Jaber S,Paugam C,Futier E,et al.Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit(BICAR-ICU):a multicentre,open-label,randomised controlled,phase 3 trial[J].Lancet,2018,392(10141):31-40.