浅谈严重烧伤后休克的防与治

摘要: 休克是严重烧伤最常见的并发症之一，也是主要致死原因之一，休克防治贯穿严重烧伤救治的全过程。严重烧伤后休克类型主要包括：烧伤后早期因大量血管内液体渗出到体表和组织间隙，而引发的血细胞比容升高型、低血容量性休克，常称为烧伤休克；大范围切开减张、消化道应激性溃疡、大面积切削痂手术等原因导致的失血性休克；各种微生物侵袭导致的感染性休克；输注药物或血液等引起的过敏性休克。从机体有效循环血量减少的原因看，烧伤休克与失血性休克同属低血容量性休克，感染性休克和过敏性休克同属血管扩张性休克。由于上述休克的发生时机、发生机制和临床表现各有特点，防治也应采取针对性策略。
- 烧伤 /
- 休克 /
- 防治
Abstract: Shock is one of the most common complications and one of the main causes of death after severe burns. The prevention and treatment of shock runs through the whole process of severe burn treatment. Shocks after severe burns, based on their causes, are mainly classified as follows: hypovolemic shock characterized by elevated hematocrit, also known as burn shock, and caused by serious leakage of intravascular fluid to body surface and interstitial spaces in the early stage of burns; hemorrhagic shock caused by large scale of incision and tension reduction, gastrointestinal stress ulcer, or large area of escharectomy and tangential excision surgery; septic shock caused by various microbial invasion; anaphylactic shock caused by infusion of drugs or blood. From the perspective of the reduction of effective circulating volume, burn shock and hemorrhagic shock are hypovolemic shocks, and septic shock and anaphylactic shock are vasodilatory shocks. As the aforementioned shocks vary in terms of occurrence timing, occurrence mechanism, and clinical manifestations, individualized strategies should be adopted for the prevention and treatment.
- Burns /
- Shock /
- Prevention and treatment
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