大面积烧伤休克期血流动力学监测的应用与评价  

Application and evaluation of hemodynamic monitoring in shock stage of extensive burns

作　　者：王光毅 Wang Guangyi(Burn Institute of PLA,Department of Burn Surgery,the First Affiliated Hospital of Naval Medical University,Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury,Chinese Academy of Medical Sciences,Shanghai 200433,China)

机构地区：[1]海军军医大学第一附属医院烧伤外科,全军烧伤研究所,中国医学科学院烧伤暨烧创复合伤救治关键技术创新单元,上海200433

出　　处：《中华烧伤杂志》2021年第2期131-135,共5页Chinese Journal of Burns

基　　金：全军后勤科研计划重大专项(AWS14C001)。

摘　　要：大面积烧伤休克期血流动力学呈现内在的、持续动态的变化规律,由休克早期的"低排高阻"逐渐过渡到回吸收期的"高排低阻",并具有明显的时间依赖性。血流动力学指标的正常值不是烧伤休克复苏的终点,追求休克期血流动力学的正常化将导致过度复苏。每小时尿量仍然是指导烧伤休克复苏的"金标准"。动态观察血流动力学指标的变化可以辅助临床治疗,在休克复苏不良、心肺肾等脏器功能损害和老年人、儿童等特殊人群具有更大的作用。In shock stage of extensive burns,the hemodynamics shows inherent and continuously dynamic changes,which gradually transits from"low output and high resistance"in early shock stage to"high output and low resistance"in the stage of edema reabsorption,with significant time-dependence.Normal values of hemodynamic parameters are not the endpoint of resuscitation for burn shock.To pursue the normalization of hemodynamic in shock stage will lead to excessive resuscitation.Urine output per hour is still the"gold standard"for burn shock resuscitation.Dynamic observation of hemodynamic variables can assist clinical treatment,and has more significant roles in refractory shock,cases combined with injuries of heart,lung or kidney,and special populations of the elderly and children.

关 键 词：烧伤 休克 血流动力学 液体复苏 

分 类 号：R644[医药卫生—外科学] R619+.6[医药卫生—临床医学] R62