毛细血管渗漏综合征液体复苏探讨  

Fluid Resuscitation of Capillary Leak Syndrome

作　　者：刘杰[1] 孟庆义[1] 

机构地区：[1]北京解放军总医院急诊科,北京100853

出　　处：《医学综述》2014年第19期3564-3567,共4页Medical Recapitulate

基　　金：国家自然科学基金面上项目(81071585)

摘　　要：毛细血管渗漏综合征(CLS)是在危重症治疗中经常遇到的一种并发症,其发病的理论机制是微循环血管内皮功能障碍导致血管壁高通透性,从而导致多器官功能不全,甚至危及生命。其治疗关键是液体复苏,其中补液量的监测指标及液体种类的选择尤为重要。与其他液体相比较,第三代羟乙基淀粉更适合CLS的治疗,但因为羟乙基淀粉也能渗漏到组织间隙,并产生自由基及其他不利影响,导致其用法及用量仍有较大争议,需在临床中进一步研究验证。Capillary leak syndrome（CLS） is a frequently encontered dilemma in the treatment of critical illnesses.The fundamental pathogenesis of CLS is microvascular endothelial dysfunction,which leads to vascular hyperpermeability,resulting in multiple organ dysfunction syndrome or death.Fluid resuscitation is the cornerstone of the treament of CLS,and the hemodynamic parameters of guided fluid infusion and selection of fluids are especially crucial.Compared with other liquid,the third-generation hydroxyethyl starch is more suitable to treat CLS,but hydroxyethyl starch can also be leaked into tissue space,producing free radicals and other adverse effects,therefore,the dosage and methods of using hydroxyethyl starch remain controversial,which needs further validation in clinical.

关 键 词：毛细血管渗漏综合征 液体复苏 羟乙基淀粉 白蛋白 

分 类 号：R459.7[医药卫生—急诊医学]