{"id":6201,"date":"2023-12-01T22:34:52","date_gmt":"2023-12-01T14:34:52","guid":{"rendered":"https:\/\/www.cosmomed.com.tw\/?p=6201"},"modified":"2023-12-05T10:50:01","modified_gmt":"2023-12-05T02:50:01","slug":"damage-control-resuscitation-and-rapid-infuser","status":"publish","type":"post","link":"https:\/\/www.cosmomed.com.tw\/en\/damage-control-resuscitation-and-rapid-infuser\/","title":{"rendered":"Damage Control Resuscitation And Fluid Management"},"content":{"rendered":"\n

\u300e\u640d\u50b7\u63a7\u5236\u300f\u4e00\u8a5e\u8d77\u6e90\u65bc\u6d77\u4e0a\u6230\u4e8b\uff0c\u6700\u521d\u662f\u7528\u4f86\u63cf\u8ff0\u6d77\u4e0a\u53d7\u640d\u8ecd\u8266\u7684\u7ba1\u7406\u65b9\u6cd5\uff0c\u5176\u76ee\u7684\u5728\u65bc\u7dad\u6301\u8239\u8266\u7684\u9069\u822a\u6027\u548c\u904b\u4f5c\u72c0\u614b\uff0c\u800c\u4e0d\u662f\u8ffd\u6c42\u4fee\u5fa9\u6240\u6709\u7684\u640d\u5bb3[1]\u3002\u540c\u6a23\u7684\u6982\u5ff5\u88ab\u904b\u7528\u5230\u6230\u5730\u91ab\u7642\uff0c\u6210\u70ba\u6230\u5834\u4e0a\u6cbb\u7642\u56b4\u91cd\u51fa\u8840\u60a3\u8005\u7684\u7cfb\u7d71\u6027\u7b56\u7565\u7a31\u4f5c\u300e\u640d\u50b7\u63a7\u5236\u5fa9\u7526\u300f(Damage Control Resuscitation, DCR)\uff0c\u76ee\u6a19\u662f\u5feb\u901f\u63a7\u5236\u75c5\u60a3\u51fa\u8840\u4e26\u7cfe\u6b63\u4f75\u767c\u7684\u51dd\u8840\u7570\u5e38\uff0c\u4ee5\u63d0\u9ad8\u56b4\u91cd\u51fa\u8840\u60a3\u8005\u7684\u5b58\u6d3b\u7387\uff0c\u800c\u5982\u4eca\u4e5f\u6210\u70ba\u73fe\u4ee3\u5316\u6c11\u751f\u91ab\u9662\u6cbb\u7642\u56b4\u91cd\u5275\u50b7\u75c5\u4eba\u7684\u6a19\u6e96\u65b9\u6cd5\u3002<\/p>\n\n\n\n

\u640d\u50b7\u63a7\u5236\u5fa9\u7526\u539f\u5247\u6709\u640d\u50b7\u63a7\u5236\u624b\u8853(Damage Control Surgery)\u3001\u5141\u8a31\u6027\u4f4e\u8840\u58d3(Permissive Hypotension)\u4ee5\u53ca\u6b62\u8840\u5fa9\u7526(Haemostatic Resuscitation)\u3002\u640d\u50b7\u63a7\u5236\u624b\u8853<\/strong>\u662f\u6307\u4f7f\u7528\u6700\u7c21\u55ae\u3001\u5feb\u901f\u7684\u65b9\u5f0f\u66ab\u6642\u6027\u7684\u593e\u9589\u3001\u6813\u585e\u3001\u5305\u7d2e\u4ee5\u63a7\u5236\u51fa\u8840\uff0c\u76ee\u7684\u662f\u6b62\u8840\u4ee5\u53ca\u6e1b\u5c11\u611f\u67d3\uff0c\u5f85\u75c5\u4eba\u6062\u5fa9\u6b63\u5e38\u751f\u7406\u6a5f\u80fd\u4ee5\u5f8c\u518d\u5b89\u6392\u624b\u8853\u57f7\u884c\u4fee\u5fa9\u5de5\u4f5c\u3002[4]<\/p>\n\n\n\n

\u5141\u8a31\u6027\u4f4e\u8840\u58d3<\/strong>\u662f\u6307\u5728\u75c5\u60a3\u51fa\u8840\u5c1a\u672a\u7372\u5f97\u63a7\u5236\u524d\u9650\u5236\u5176\u8f38\u6db2\u91cf\uff0c\u8b93\u75c5\u4eba\u4fdd\u6301\u5728\u53ef\u5141\u8a31\u7684\u4f4e\u8840\u58d3\u72c0\u614b\u3002\u7531\u65bc\u8840\u7ba1\u58d3\u529b\u8d8a\u9ad8\uff0c\u6b62\u8840\u5c31\u8d8a\u56f0\u96e3\uff0c\u56e0\u70ba\u6db2\u9ad4\u6703\u5c07\u525b\u51dd\u7d50\u7684\u8840\u6813\u6c96\u6389\uff0c\u5c0e\u81f4\u51fa\u8840\u91cd\u65b0\u958b\u59cb\uff0c\u56e0\u6b64\u5617\u8a66\u4f7f\u8840\u58d3\u6b63\u5e38\u5316\u53ef\u80fd\u53cd\u800c\u5c0e\u81f4\u5931\u8840\u91cf\u589e\u52a0\u4e26\u60e1\u5316\u7d50\u679c\uff0c\u63db\u53e5\u8a71\u8aaa\u4f4e\u8840\u58d3\u6709\u52a9\u65bc\u6b62\u8840\u3002[2]<\/p>\n\n\n

\n
\"\u5feb\u901f\u8f38\u6db2\u7cfb\u7d71\u642d\u914dMTP\u8a08\u5206\u677f\u8ffd\u8e64\u8f38\u8840\u6bd4\u4f8b\"
MTP\u8a08\u5206\u677f<\/a>\u8f14\u52a9\u640d\u50b7\u63a7\u5236\u5fa9\u7526\u904e\u7a0b\u4e2d\u8ffd\u8e64\u8f38\u8840\u6bd4\u4f8b<\/figcaption><\/figure>\n<\/div>\n\n\n

\u6b62\u8840\u5fa9\u7526<\/strong>\u662f\u6307\u5118\u65e9\u8f38\u6ce8\u5168\u8840\u6216\u662f\u7b49\u6bd4\u4f8b\u8f38\u6ce8\u7d05\u8840\u7403\u3001\u8840\u6f3f\u3001\u8840\u5c0f\u677f\u7b49\u6210\u4efd\u8840\u4ee5\u53d6\u4ee3\u6676\u9ad4\u6eb6\u6db2\u3002\u7531\u65bc\u6676\u9ad4\u6eb6\u6db2\u4e0d\u5305\u542b\u51dd\u8840\u56e0\u5b50\u4ee5\u53ca\u7d05\u8840\u7403\uff0c\u8f38\u6ce8\u5927\u91cf\u6676\u9ad4\u6eb6\u6db2\u53ef\u80fd\u5c0e\u81f4\u7a00\u91cb\u6027\u51dd\u8840\u7570\u5e38(Dilutional Coagulopathy)\u4e26\u4e14\u7121\u6cd5\u63d0\u4f9b\u7d44\u7e54\u8db3\u5920\u6c27\u6c23\uff0c\u56e0\u6b64\u61c9\u8a72\u76e1\u53ef\u80fd\u6e1b\u5c11\u8f38\u6ce8\u6676\u9ad4\u6eb6\u6db2\u3002<\/p>\n\n\n\n

\u70ba\u4e86\u9054\u5230\u6700\u5927\u6cbb\u7642\u6548\u679c\uff0c\u640d\u50b7\u63a7\u5236\u5fa9\u7526\u539f\u5247\u5efa\u8b70\u900f\u904e\u5feb\u901f\u8f38\u8840\u5668\u3001\u8840\u6db2\u52a0\u6eab\u5668\u9032\u884c\u8f38\u8840[5]\u3002\u4f46\u8981\u9075\u5faa\u5141\u8a31\u6027\u4f4e\u8840\u58d3\u539f\u5247\u4e0b\uff0c\u8f38\u8840\u901f\u7387\u5c31\u61c9\u7576\u8981\u53d7\u5230\u56b4\u683c\u63a7\u7ba1\uff0c\u907f\u514d\u904e\u9ad8\u7684\u6d41\u901f\u9020\u6210\u75c5\u4eba\u8840\u58d3\u8fc5\u901f\u4e0a\u5347\uff0c\u751a\u81f3\u65bc\u4f75\u767c\u5faa\u74b0\u904e\u8f09(Transfusion-associated circulatory overload, TACO)[6]\uff0c\u56e0\u6b64\u6d41\u901f\u7a69\u5b9a\u4e14\u53ef\u63a7\u7684\u8f38\u8840\u5668\u76f8\u4fe1\u6703\u66f4\u9069\u5408\u640d\u50b7\u63a7\u5236\u5fa9\u7526[3]\u3002\u5982\u8c9d\u723e\u66fc\u7279\u8f38\u6db2\u7ba1\u7406\u7cfb\u7d71<\/a>\u5373\u662f\u5c11\u6578\u5177\u5099\u5e6b\u6d66\u7684\u5feb\u901f\u8f38\u6db2\u7cfb\u7d71\uff0c\u5b83\u53ef\u4ee5\u7cbe\u6e96\u8a2d\u5b9a\u6d41\u901f\u5f9e\u6700\u61622.5 ml\/min\u5230\u6700\u9ad8750 ml\/min\uff0c\u61c9\u6620\u4e0d\u540c\u75c5\u4eba\u9ad4\u578b\u3001\u75c5\u60c5\u8b8a\u5316\u3001\u7b56\u7565\u9700\u6c42\u5373\u6642\u8abf\u6574\u6d41\u901f\uff0c\u5728\u7f8e\u570b\u7a7a\u8ecd\u8056\u8def\u6613\u5275\u50b7\u8207\u6280\u80fd\u6e96\u5099\u4e2d\u5fc3(Saint Louis Center for Sustainment of Trauma and Readiness Skills, C-Star)\u3001\u6fb3\u6d32\u9678\u8ecd\u99d0\u4f0a\u62c9\u514b\u5854\u5409\u8ecd\u4e8b\u7d9c\u5408\u91ab\u7642\u57fa\u5730(Taji Military Complex Medical Facility, Iraq)\u4ee5\u53ca\u82f1\u570b\u7687\u5bb6\u6d77\u8ecd\u8266\u968a(Royal Fleet Auxiliary)\u90fd\u5df2\u7d93\u914d\u5099\u9019\u985e\u578b\u7684\u8f38\u8840\u5668\u8f14\u52a9\u91ab\u7642\u5718\u968a\u70ba\u4efb\u52d9\u4e2d\u53d7\u50b7\u7684\u5b98\u58eb\u5175\u57f7\u884c\u73fe\u4ee3\u5316\u6025\u6551\u91ab\u7642\u4f5c\u696d[6]\u3002<\/p>\n\n\n\n

\n
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\u7f8e\u570b\u7a7a\u8ecd\u8056\u8def\u6613\u5275\u50b7\u8207\u6280\u80fd\u6e96\u5099\u4e2d\u5fc3<\/figcaption><\/figure>\n\n\n\n
\n
<\/div>\n<\/div>
\u6fb3\u6d32\u9678\u8ecd\u99d0\u4f0a\u62c9\u514b\u5854\u5409\u8ecd\u4e8b\u7d9c\u5408\u91ab\u7642\u57fa\u5730<\/figcaption><\/figure>\n\n\n\n
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\u82f1\u570b\u6d77\u8ecd\u963f\u683c\u65af\u865f\u5feb\u901f\u8f38\u6db2\u7cfb\u7d71(\u4e0a\u5716\u53f3\u4e8c)<\/figcaption><\/figure>\n\n\n\n

\u53c3\u8003\u8cc7\u6599\uff1a<\/strong><\/p>\n\n\n\n

    \n
  1. Giannoudi M, Harwood P. Damage control resuscitation: lessons learned<\/a>. Eur J Trauma Emerg Surg. 2016 Jun;42(3):273-82. doi: 10.1007\/s00068-015-0628-3. Epub 2016 Feb 4. PMID: 26847110; PMCID: PMC4886149.<\/li>\n\n\n\n
  2. Duchesne JC, Pereira BM, Fraga GP. Damage Control Resuscitation<\/a>. Trauma Surgery. 2013 Aug 19:27\u201342. doi: 10.1007\/978-88-470-5403-5_3. PMCID: PMC7120797.<\/li>\n\n\n\n
  3. Woolley T, Thompson P, Kirkman E, Reed R, Ausset S, Beckett A, Bjerkvig C, Cap AP, Coats T, Cohen M, Despasquale M, Dorlac W, Doughty H, Dutton R, Eastridge B, Glassberg E, Hudson A, Jenkins D, Keenan S, Martinaud C, Miles E, Moore E, Nordmann G, Prat N, Rappold J, Reade MC, Rees P, Rickard R, Schreiber M, Shackelford S, Skogran Eliassen H, Smith J, Smith M, Spinella P, Strandenes G, Ward K, Watts S, White N, Williams S. Trauma Hemostasis and Oxygenation Research Network position paper on the role of hypotensive resuscitation as part of remote damage control resuscitation<\/a>. J Trauma Acute Care Surg. 2018 Jun;84(6S Suppl 1):S3-S13. doi: 10.1097\/TA.0000000000001856. PMID: 29799823.<\/li>\n\n\n\n
  4. Schreiber MA. Damage control surgery<\/a>. Crit Care Clin. 2004 Jan;20(1):101-18. doi: 10.1016\/s0749-0704(03)00095-2. PMID: 14979332.<\/li>\n\n\n\n
  5. American College of Surgeons. TQIP. Massive transfusion in trauma guidelines<\/a>. ACS, Chicago. 2013<\/li>\n\n\n\n
  6. Seal G, Stables A, Mercer SJ. Training for damage control resuscitation using a rapid infuser.<\/a> J R Army Med Corps. 2017 Feb;163(1):76. doi: 10.1136\/jramc-2016-000711. Epub 2016 Oct 27. PMID: 27789661.<\/li>\n\n\n\n
  7. Coagulopathy, An Issue of Oral and Maxillofacial Surgery Clinics of North America by Jeffrey D. Bennett<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    \u640d\u50b7\u63a7\u5236\u4e00\u8a5e\u8d77\u6e90\u65bc\u6d77\u4e0a\u6230\u4e8b\uff0c\u6700\u521d\u662f\u7528\u4f86\u63cf\u8ff0\u6d77\u4e0a\u53d7\u640d\u8ecd\u8266\u7684\u7ba1\u7406\u65b9\u6cd5\uff0c\u5176\u76ee\u7684\u5728\u65bc\u7dad\u6301\u8239\u8266\u7684\u9069\u822a\u6027\u548c\u904b\u4f5c\u72c0\u614b\uff0c\u800c\u4e0d\u662f\u8ffd\u6c42\u4fee\u5fa9\u6240\u6709\u7684\u640d\u5bb3\uff0c\u540c\u6a23\u7684\u6982\u5ff5\u904b\u7528\u5230\u6230\u5730\u91ab\u7642<\/p>","protected":false},"author":1,"featured_media":6214,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[65],"tags":[66,127,481,222,94,482,102,101,67,111,110,96],"class_list":["post-6201","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-info","tag-belmont-rapid-infuser","tag-cosmo-medical","tag-dcr","tag-fms2000","tag-ri-2","tag-482","tag-102","tag-101","tag-67","tag-111","tag-110","tag-96"],"jetpack_featured_media_url":"https:\/\/www.cosmomed.com.tw\/wp-content\/uploads\/2023\/12\/DCR_and_RapidInfuserv4.jpg","jetpack_shortlink":"https:\/\/wp.me\/paJTt6-1C1","rttpg_featured_image_url":{"full":["https:\/\/www.cosmomed.com.tw\/wp-content\/uploads\/2023\/12\/DCR_and_RapidInfuserv4.jpg",444,295,false],"landscape":["https:\/\/www.cosmomed.com.tw\/wp-content\/uploads\/2023\/12\/DCR_and_RapidInfuserv4.jpg",444,295,false],"portraits":["https:\/\/www.cosmomed.com.tw\/wp-content\/uploads\/2023\/12\/DCR_and_RapidInfuserv4.jpg",444,295,false],"thumbnail":["https:\/\/www.cosmomed.com.tw\/wp-content\/uploads\/2023\/12\/DCR_and_RapidInfuserv4-300x199.jpg",300,199,true],"medium":["https:\/\/www.cosmomed.com.tw\/wp-content\/uploads\/2023\/12\/DCR_and_RapidInfuserv4-400x266.jpg",400,266,true],"large":["https:\/\/www.cosmomed.com.tw\/wp-content\/uploads\/2023\/12\/DCR_and_RapidInfuserv4.jpg",444,295,false],"1536x1536":["https:\/\/www.cosmomed.com.tw\/wp-content\/uploads\/2023\/12\/DCR_and_RapidInfuserv4.jpg",444,295,false],"2048x2048":["https:\/\/www.cosmomed.com.tw\/wp-content\/uploads\/2023\/12\/DCR_and_RapidInfuserv4.jpg",444,295,false],"trp-custom-language-flag":["https:\/\/www.cosmomed.com.tw\/wp-content\/uploads\/2023\/12\/DCR_and_RapidInfuserv4-18x12.jpg",18,12,true],"hestia-blog":["https:\/\/www.cosmomed.com.tw\/wp-content\/uploads\/2023\/12\/DCR_and_RapidInfuserv4-360x240.jpg",360,240,true],"woocommerce_thumbnail_2x":["https:\/\/www.cosmomed.com.tw\/wp-content\/uploads\/2023\/12\/DCR_and_RapidInfuserv4.jpg",444,295,false],"woocommerce_thumbnail":["https:\/\/www.cosmomed.com.tw\/wp-content\/uploads\/2023\/12\/DCR_and_RapidInfuserv4-230x230.jpg",230,230,true],"woocommerce_single":["https:\/\/www.cosmomed.com.tw\/wp-content\/uploads\/2023\/12\/DCR_and_RapidInfuserv4.jpg",444,295,false],"woocommerce_gallery_thumbnail":["https:\/\/www.cosmomed.com.tw\/wp-content\/uploads\/2023\/12\/DCR_and_RapidInfuserv4-160x160.jpg",160,160,true]},"rttpg_author":{"display_name":"pohsun","author_link":"https:\/\/www.cosmomed.com.tw\/en\/author\/pohsun\/"},"rttpg_comment":0,"rttpg_category":"\u8cc7\u8a0a<\/a>","rttpg_excerpt":"\u640d\u50b7\u63a7\u5236\u4e00\u8a5e\u8d77\u6e90\u65bc\u6d77\u4e0a\u6230\u4e8b\uff0c\u6700\u521d\u662f\u7528\u4f86\u63cf\u8ff0\u6d77\u4e0a\u53d7\u640d\u8ecd\u8266\u7684\u7ba1\u7406\u65b9\u6cd5\uff0c\u5176\u76ee\u7684\u5728\u65bc\u7dad\u6301\u8239\u8266\u7684\u9069\u822a\u6027\u548c\u904b\u4f5c\u72c0\u614b\uff0c\u800c\u4e0d\u662f…","_links":{"self":[{"href":"https:\/\/www.cosmomed.com.tw\/en\/wp-json\/wp\/v2\/posts\/6201","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.cosmomed.com.tw\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.cosmomed.com.tw\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.cosmomed.com.tw\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.cosmomed.com.tw\/en\/wp-json\/wp\/v2\/comments?post=6201"}],"version-history":[{"count":37,"href":"https:\/\/www.cosmomed.com.tw\/en\/wp-json\/wp\/v2\/posts\/6201\/revisions"}],"predecessor-version":[{"id":6261,"href":"https:\/\/www.cosmomed.com.tw\/en\/wp-json\/wp\/v2\/posts\/6201\/revisions\/6261"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.cosmomed.com.tw\/en\/wp-json\/wp\/v2\/media\/6214"}],"wp:attachment":[{"href":"https:\/\/www.cosmomed.com.tw\/en\/wp-json\/wp\/v2\/media?parent=6201"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.cosmomed.com.tw\/en\/wp-json\/wp\/v2\/categories?post=6201"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.cosmomed.com.tw\/en\/wp-json\/wp\/v2\/tags?post=6201"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}