创伤失血性休克中国急诊专家共识(2023)

中国人民解放军急救医学专业委员会; 中国医师协会急诊医师分会; 北京急诊医学学会; 中国急诊专科医联体

doi:10.13201/j.issn.1009-5918.2023.12.01

创伤失血性休克中国急诊专家共识(2023)

详细信息

执笔作者：陈翔宇，陆军军医大学西南医院(重庆，400038)
刘红升，中国人民解放军总医院第四医学中心(北京，100048)
向强，陆军军医大学西南医院(重庆，400038)
刘双庆，中国人民解放军总医院第四医学中心(北京，100048)
通信作者：刘明华，陆军军医大学西南医院，E-mail：minghua_liu@tmmu.edu.cn
赵晓东，中国人民解放军总医院第四医学中心，E-mail：zxd63715@126.com
于学忠，北京协和医院，E-mail：yxz@pumch.cn

中图分类号: R605.971

收稿日期: 2023-10-10

网络出版日期: 2023-11-17

刊出日期: 2023-12-10

Expert consensus on the diagnosis and treatment of traumatic hemorrhagic shock in China(2023)

Corresponding author: LIU Minghua, E-mail: minghua_liu@tmmu.edu.cn; ZHAO Xiaodong, E-mail: zxd63715@126.com; YU Xuezhong, E-mail: yxz@pumch.cn

Received Date: 10 October 2023

Available Online: 17 November 2023

Publish Date: 10 December 2023

摘要

摘要: 创伤失血性休克是严重创伤后“可预防性死亡”的主要原因。目前我国创伤失血性休克诊疗的规范性仍有待提高，为此我们组织了国内多个学术组织的急诊专家，基于最新的临床与基础研究证据，权衡患者获益程度，编写了适用于院前急救、院内救治等创伤失血性休克不同阶段的专家共识，旨在为中国急诊医生规范救治创伤失血性休克患者提供系统、全面的参考依据。
- 创伤失血性休克 /
- 诊断 /
- 治疗 /
- 专家共识
Abstract: Hemorrhagic shock remains a leading cause of "potentially preventable death" among severe traumatic injured patients. However, the current situation regarding the diagnosis and treatment of traumatic hemorrhagic shock in our country is not ideal. To standardize and improve the level of diagnosis and treatment of traumatic hemorrhagic shock in China, it is necessary to establish a consensus that is practical and adapted to the conditions in China. We estimated value of the latest clinical and research evidence in given clinical scenarios by a joint committee of multidisciplinary experts. This expert consensus addresses the diagnosis, on-site emergency procedures, in-hospital treatment, and complications prevention of traumatic hemorrhagic shock.
- traumatic hemorrhagic shock /
- diagnosis /
- treatment /
- expert consensus

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图 1 创伤失血性休克诊疗决策流程图

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表 1 本共识中采用的临床证据分级标准

推荐等级	各等级代表的意义	收益、风险与负担之间的关系	支持证据的文献质量
1A	推荐力度大；证据质量高	收益明显大于风险和负担，反之亦然	无重要限制的随机对照研究或具有压倒性证据的观察研究
1B	推荐力度大；证据质量中等	收益明显大于风险和负担，反之亦然	有重要限制的随机对照研究或具有高质量证据的观察研究
1C	推荐力度大；证据质量低或极低	收益明显大于风险和负担，反之亦然	观察性研究或病例分析
2A	推荐力度小；证据质量高	收益与风险、负担持平	无重要限制的随机对照研究或具有压倒性证据的观察研究
2B	推荐力度小；证据质量中等	收益与风险、负担持平	有重要限制的随机对照研究或具有高质量证据的观察研究
2C	推荐力度小；证据质量低或极低	无法评估收益、风险与负担之间的关系；收益、风险与负担之间可能持平	观察性研究或病例分析

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表 2 创伤失血性休克严重程度分级

SI	预计失血量/%	严重程度
≥1.0	20~30	轻度
≥1.5	30~50	中度
≥2.0	50~70	重度

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