容量管理认识面面观  

The Principles of Volume Management

作　　者：黄薇 张宏民 王小亭 刘大为 HUANG Wei;ZHANG Hong-min;WANG Xiao-ting;LIU Da-wei(Department of Critical Care Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院重症医学科

出　　处：《协和医学杂志》2019年第5期450-455,共6页Medical Journal of Peking Union Medical College Hospital

摘　　要：容量管理是重症患者治疗的重要内容之一,贯穿血流动力学治疗的全过程,而液体复苏则是容量管理的关键环节。容量过多或过少均对患者不利,合理的容量管理才可改善预后。液体常常被用来保证和维持组织器官灌注,是休克治疗的重要手段之一。前期的液体复苏应个体化仔细滴定、迅速达到合适的容量状态,并在复苏同时避免不必要的并发症。因此,如何使液体复苏精细到恰如其分,是目前重症治疗的难点之一。关于液体复苏的原则目前仍未达成一致,液体复苏何时开始、如何进行、何时暂停,甚至液体种类的选择均充满争议。本文总结笔者关于容量管理的相关经验,对其进行论述。Fluid management is one of the crucial interventions in critically ill patients,which runs through the whole process of hemodynamic therapy,and fluid resuscitation is the key part.Either too much or too little volume can have a negative impact on patient outcome.Only adequate volume status could improve prognosis.Early fluid resuscitation should be titrated carefully for each patient,reaching the target quickly and avoiding complications.Therefore,how to maintain an appropriate volume status is challenging.Nevertheless,the rules of fluid resuscitation are still controversial:when to start,how to proceed,when to finish?Even the type of fluid selected is far from a consensus.This article tends to summarize some experience in fluid management.

关 键 词：容量管理 液体复苏 血流动力学治疗 

分 类 号：R441.9[医药卫生—诊断学] R451[医药卫生—临床医学]