| 摘要: |
| 由战伤导致的机体损伤往往伤情复杂、范围广泛，易累及深部器官和组织。其中部分伤员存在失血性休克、病情危急，常需行损伤控制性手术，对该类伤员的麻醉管理是一项具有挑战性的工作。本文介绍了战创伤伤员行损伤控制手术的麻醉方式和麻醉药物的选择，重点讨论了气道评估、困难气道的处理及可疑颈椎损伤和吸入性烧伤的气道管理问题，并探讨了容许性低血压、输液输血和死亡三联征等难点，为指导战现场条件下损伤控制性手术的麻醉实施、提高救治水平提供参考。 |
| 关键词: 损伤控制性手术 麻醉 气道管理 容许性低血压 |
| DOI：10.16781/j.CN31-2187/R.20210726 |
| 投稿时间：2021-07-27修订日期：2022-06-29 |
| 基金项目:联勤保障部队战勤部重点项目（BLB18C007），海军军医大学（第二军医大学）未来战争医学防护技术研发专项面上项目（19WLMS-06）. |
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| Anesthesia for damage control surgery of combat wounds |
| FAN Xiao-hua1,YANG Ru-nan2,WANG Zhen-meng2* |
(1. Department of Anesthesiology, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China;
2. Department of Anesthesiology, The Third Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200438, China
*Corresponding author) |
| Abstract: |
| The damage caused by combat is complex and extensive, and the deep organs and tissue are usually implicated. Some of these wounded patients have hemorrhagic shock and are in critical condition. The damage control surgery is necessary, while the anesthesia management is challenging. This article introduces the anesthesia methods and anesthetics for damage control surgery of combat wounds, focuses on airway management (including airway evaluation, difficult airway management, as well as measures for suspected cervical spine injury and inhalation injury), and discusses the difficulties such as permissive hypotension, transfusion and lethal triad, which provides a reference for guiding the implementation of anesthesia and improving the treatment for damage control surgery in combat field. |
| Key words: damage control surgery anesthesia airway management permissive hypotension |
