失血性休克的研究与治疗进展

失血性休克常常导致血压降低，使组织代谢不能维持有氧代谢。显著的血管容量降低将导致血液动力学不稳定，降低组织灌注，细胞内缺氧，器官损伤和死亡。输注晶体或胶体液和血制品能够挽救严重的失血性休克患者。但是，满意的液体复苏方法还没有确立。对于活动性出血的患者血红蛋白值不能作为唯一的治疗指标，治疗时应综合观察血容量的恢复情况和血液动力学参数变化。本综述就失血导致的低血容量休克，即失血性休克的病理生理学变化以及液体复苏的相关性进行分析，以提高对失血性休克的认识，为今后的临床治疗与研究奠定基础。

The research and therapeutic progress on hemorrhagic shock

Life-threatening decreases in blood pressure often are associated with a condition in which tissue perfusion is not capable of sustaining aerobic metabolism. Significant loss of intravascular volume may lead sequentially to hemodynamic instability, decreased tissue perfusion, cellular hypoxia, organ damage, and death. Intravenous crystalloids or colloids, and blood products can be life saving in those patients who are in severe hemorrhagic shock. The optimal method of resuscitation has not been established. However, hemoglobin concentration should not be the only therapeutic guide in actively bleeding patients. Instead, therapy should be aimed at restoring intravascular volume and the change of hemodynamic parameters. This review addresses on pathophysiology and resuscitation of hemorrhagic shock, and promote recognition of hemorrhageic shock in order to establish foundation of clinical therapy and research.