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Historically, hemorrhage accounts for the primary cause of death on the battlefield in conventional warfare. In addition, hemorrhage was associated with 85% of potentially survivable deaths in the current conflicts, approximately two-thirds of which were from noncompressible injuries. Future combat casualty care strategies suggest the likelihood of long transport times or significant time delays in evacuation of casualties. In addition, there are logistical limitations to providing large volumes of resuscitation fluid far-forward, and current guidelines do not recommend infusing large volumes of fluid until bleeding is controlled. Since the medic has few options for treating noncompressible injuries short of infusing fluid to maintain a blood pressure, the concept of damage control resuscitation was developed to promote hemostatic resuscitation. Damage control resuscitation recommends limiting the amount of crystalloids or colloids infused and using plasma and other blood products in more optimal ratios for the treatment of severe hemorrhage to improve battlefield survival and to reduce or prevent early and late deleterious sequelae. Taken together, these efforts have important implications towards the development of optimal fluid resuscitation strategies for stabilization of the combat casualty. |
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quzuoyin
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爱与雨下(金币+1): 感谢应助 2011-08-22 10:52:58
huona(金币+20, 翻译EPI+1): 2011-08-24 22:21:46
爱与雨下(金币+1): 感谢应助 2011-08-22 10:52:58
huona(金币+20, 翻译EPI+1): 2011-08-24 22:21:46
| 历史上，大出血是常见战争中战场上死亡的主要原因。而且，在现代冲突中大出血与85%的幸存者的潜在死亡有关，大约三分之二的死亡属于非压缩性损伤。未来战争伤员护理策略表明伤员的长时间运输与撤退时间的延误是很可能发生的。此外，有限的后勤不能为前线提供大量的复苏液，目前的指导方针没有建议在出血被控制之前大量注射液体。由于医务兵缺少复苏液来维持血压，他在治疗非压缩性损伤的时候几乎没有选择，损伤控制复苏的概念被人们发展来提高出血的复苏。损伤控制复苏建议减少使用晶体或胶体注射的量，而以更为合理的比例使用血浆和其他一些血液制品来治疗严重出血，以此来提高战场存活率并减少或避免始终存在的有害后遗症。总之，这些努力为稳定战争伤员的最优液体复苏策略的发展有着重要的意义。 |
2楼2011-08-22 10:43:47
