长时间受困地震伤员早期大容量液体治疗的效果
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摘要
目的探讨地震过后长时间受困伤员早期大容量液体治疗的效果。方法地震后受困超过96h的伤员8例,根据当时的条件给予不同方式和数量的液体治疗,以救出后2h的休克指数等作为液体复苏情况的判定指标。结果8例伤员均恢复良好,尤其是3例早期给予口服补液和电解质、早期大量使用代血浆的伤员休克纠正效果明显。结论长时间受困地震伤员应早期给予大容量液体复苏治疗,纠正酸中毒和电解质失衡对早期保证伤员的存活至关重要。
Objective To investigate the efficacy of high volume fluid therapy in the survivors under ruin after earthquake for a long time.Methods Eight patients restricted under ruin after earthquake for over 96 hours were given different kinds and volumes of fluids.The outcomes were evaluated with shock index in first 2 hours.Results Eight patients recovered well,especially 3 cases given high volume fluid and electrolytes by oral and plasma substitutes infusion at early time.Conclusion Early high volume fluid resuscitation combined with sufficient electrolytes and corection of acidosis is very important for the survivors who were under ruin after earthquake for a long time.
Objective To investigate the efficacy of high volume fluid therapy in the survivors under ruin after earthquake for a long time.Methods Eight patients restricted under ruin after earthquake for over 96 hours were given different kinds and volumes of fluids.The outcomes were evaluated with shock index in first 2 hours.Results Eight patients recovered well,especially 3 cases given high volume fluid and electrolytes by oral and plasma substitutes infusion at early time.Conclusion Early high volume fluid resuscitation combined with sufficient electrolytes and corection of acidosis is very important for the survivors who were under ruin after earthquake for a long time.
引文
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[7]鲁卫华,金孝,朱美芳,等.羟乙基淀粉130/0.4急性高容量血液稀释对骨科手术患者内环境的影响.临床麻醉学杂志,2008,24:379-381.
[8]金善良,彭章龙,于布为,等.不同血浆代用品行诱导期急性超容液体填充产生输液效应的比较.临床麻醉学杂志,2008,24:174-175.
[2]Scapellato S,Maria S,Castorina G,et al.Crush syndrome.Minerva Chir,2007,62:285-292.
[3]Matsuki A.Newstudy on the history of anesthesiology-(12).Abiography of Seigo Minami,the first to describe crush syn-drome.Masui,2006,55:222-228.
[4]Fukagawa M.Nephrologyin earthquakes:sharing experiences andinformation.Clin J AmSoc Nephrol,2007,2:803-808.
[5]Altintepe L,Guney I,Tonbul Z,et al.Early and intensive fluid replacement prevents acute renal failureinthe crush cases associated with spontaneous collapse of an apart ment in Konya.Ren Fail,2007,29:737-741.
[6]Gunal AI,Celiker H,Dogukan A,et al.Early and vigorous fluid resuscitation prevents acute renal failure in the crush vic-ti ms of catastrophic earthquakes.J Am Soc Nephrol,2004,15:1862-1867.
[7]鲁卫华,金孝,朱美芳,等.羟乙基淀粉130/0.4急性高容量血液稀释对骨科手术患者内环境的影响.临床麻醉学杂志,2008,24:379-381.
[8]金善良,彭章龙,于布为,等.不同血浆代用品行诱导期急性超容液体填充产生输液效应的比较.临床麻醉学杂志,2008,24:174-175.
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