汶川大地震伤员围术期的液体治疗
摘要
目的:探讨地震伤员在围术期的体液丢失特点和治疗措施。方法:收集5月12日至5月19日的184例地震受伤手术病人,对其受伤情况,术前合并症,麻醉手术日期,围术期的液体治疗情况进行统计和分析,总结经验教训,尽量减少围术期地震伤员的死亡率。结果:3例死于严重高钾血症致呼吸心跳骤停,1例死于大出血,1例死于肺栓塞,1例死于多器官功能衰竭,1例死于大面积肌肉坏死、肾衰竭、感染性休克,177例伤员存活。结论:地震伤员重点要考虑麻醉手术前非正常的体液丢失和麻醉手术期间体液的再分布。尽快了解伤员体液丢失情况,维持伤员围术期体液的平衡。
引文
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[2]Sever MS,Erek E,Vanholder R.Serum potasstum in the crush syndrome victims of the Marmara disaster[J].Clin Nephrol,2003, 59:326-333
[3]刘俊杰,赵俊主编.现代麻醉学[M].第2版.北京:人民卫生出版社,2000.341-342
[4]Rivers E,Nguyen B,Havstad S,et al.Early goaldirected therapy in the treatment of severe sepsis and septic shock.[J].N Engl J Med,2001,345(19):1368 - 1377
[5]吴肇汉.外科病人液体治疗的现代概念[J].外科理论与实践, 2004,9(4):343-344
[6]Choi PT,Yip G,Quinonez LG.Crystalloid vs.Colloid in fluid resuscitation?: a systematic review[J].Crit Care Med,1999,27(1): 200-2010
[7]邓硕曾.围术期液体治疗的进展与评价[J].临床麻醉学杂志, 2003,19(7):439-441
[8]Schortgen F,Lacherade JC,Bruneel F,et al.Effects of hydroxyethylstarch and gelatin on renal function in severe sepsis:a multicentrer and randomised study[J].Lancet,2001,357:911 -916
[9]Better OS,Stein JH.Early management of shock and prophylaxis of acute renal failure in traumatic rhabdomyolysis[J].N Engl J Med,1990,322:825 -829
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