烧伤休克期液体复苏有创监测指标的利与弊  

The advantages and disadvantages of hemodynamic monitoring during fluid resuscitation during burn shock phase

作　　者：侯琪 黄俊 徐华康 刘顺利 HOU Qi;HUANG Jun;XU Huakang;LIU Shunli(Department of Burn and Plastic Surgery,The 960 Hospital of PLA,Jinan 250031,China)

机构地区：[1]中国人民解放军联勤保障部队第九六○医院烧伤整形科,山东济南250031 [2]济南市中心医院烧伤整复外科,山东济南250000 [3]锦州医科大学,辽宁锦州121001

出　　处：《中国美容整形外科杂志》2024年第11期688-691,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：发生烧伤后,血浆样液体快速向组织间隙及皮肤破损处渗漏,导致有效循环血量急剧减少,患者进入休克期,此时首要的治疗措施即实施快速高效的液体复苏。在运用补液公式的基础上,进行有效的“个体化”复苏,通过选择恰当的监测指标评估复苏效果、指导复苏进程、避免复苏不力或过度复苏成为了烧伤患者休克期液体复苏的核心问题。笔者对现有文献及参考资料进行归纳总结,讨论烧伤患者在休克期液体复苏的过程中对于指导液体复苏、评估复苏效果有参考价值的各项有创监测指标的应用进展,为烧伤患者休克期液体复苏的诊疗过程提供参考。After a burn,plasma like fluid rapidly leaks into tissue gaps and skin lesions,leading to a sharp decrease in effective circulating blood volume and the patient entering the shock phase.At this time,the primary treatment measure is to implement rapid and efficient fluid resuscitation.On the basis of using the formula for fluid resuscitation,effective individualized resuscitation is carried out.The core issue of fluid resuscitation in burn patients during the shock phase is to select appropriate monitoring indicators to evaluate the resuscitation effect,guide the resuscitation process,and avoid ineffective or excessive resuscitation.This article summarizes existing literature and reference materials to discuss the application progress of various invasive monitoring indicators that have reference value for guiding fluid resuscitation and evaluating the effectiveness of resuscitation in burn patients during the shock phase fluid resuscitation process,providing reference for the diagnosis and treatment process of burn patients during shock phase fluid resuscitation.

关 键 词：烧伤休克 液体复苏 有创监测指标 过度复苏 液体蠕变 

分 类 号：R644[医药卫生—外科学]