【摘要】 严重创伤出血患者的早期综合救治仍然是新形势下面临的巨大挑战。临床实践的进步创新了出血控制的集束化策略,包括初始创伤团队与强化治疗团队提供连续照护;持续压迫或使用止血带控制灾难性大出血;实施损害控制性复苏直至大出血控制;时间窗内使用氨甲环酸抗纤维蛋白溶解;早期使用复苏性主动脉球囊阻断暂时性控制不可压迫性出血;使用骨盆带和外支架固定稳定前后环破坏的血流动力学不稳定骨盆骨折;腹膜外填塞止血;损害控制外科手术时间提前与手术时间控制;动脉造影介入栓塞时间提前与手术时间控制和输注平衡比例的血制品并以目标为导向早期立即纠正凝血功能障碍。基于损害控制基本原则个体化实施出血控制集束化新策略,是降低出血患者早期病死率的有效途径。更多还原

【Abstract】 The early treatment of seriously injured hemorrhagic patients is still a great challenge.A bundle of bleeding control strategies have been proposed,including continuous care by the initial trauma team and intensive care team,continuous compression or the use of tourniquets to control catastrophic bleeding,damage control resuscitation until bleeding controlled,use of tranexamic acid for antifibrinolysis,resuscitative balloon occlusion of aorta for temporary control of incompressible hemorrhage,the use of pelvic band and bracket for external fixation of hemodynamically unstable pelvic fractures with broken anterior and posterior rings,extraperitoneal packing,time ahead of surgery and arteriographic embolization and massive transfusion protocol.Based on the basic principle of damage control,it is an effective way to reduce the early mortality of seriously injured patients with new cluster strategy for traumatic hemorrhage control.更多还原