中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2012年
3期
220-223
,共4页
血流动力学类型%循环衰竭%儿童
血流動力學類型%循環衰竭%兒童
혈류동역학류형%순배쇠갈%인동
Hemodynamic classification%Circulatory failure%Children
通常按血流动力学变化将循环衰竭分为“暖休克”和“冷休克”,严重循环衰竭患儿往往这两种情况并存.小儿循环功能衰竭特点是血流动力学变化迅速,常伴有血管床的张力改变、血容量相对或绝对不足、心肌抑制、血流分布异常和细胞代谢障碍等.主要治疗手段是通过容量复苏、正性肌力药物和血管活性药物的应用,提高心输出量和组织灌注,实现SVO2>70%和心脏指数达到3.3~6.0L/(min·m2),以保障血管内容量和心脏负荷的最佳化调节.
通常按血流動力學變化將循環衰竭分為“暖休剋”和“冷休剋”,嚴重循環衰竭患兒往往這兩種情況併存.小兒循環功能衰竭特點是血流動力學變化迅速,常伴有血管床的張力改變、血容量相對或絕對不足、心肌抑製、血流分佈異常和細胞代謝障礙等.主要治療手段是通過容量複囌、正性肌力藥物和血管活性藥物的應用,提高心輸齣量和組織灌註,實現SVO2>70%和心髒指數達到3.3~6.0L/(min·m2),以保障血管內容量和心髒負荷的最佳化調節.
통상안혈류동역학변화장순배쇠갈분위“난휴극”화“랭휴극”,엄중순배쇠갈환인왕왕저량충정황병존.소인순배공능쇠갈특점시혈류동역학변화신속,상반유혈관상적장력개변、혈용량상대혹절대불족、심기억제、혈류분포이상화세포대사장애등.주요치료수단시통과용량복소、정성기력약물화혈관활성약물적응용,제고심수출량화조직관주,실현SVO2>70%화심장지수체도3.3~6.0L/(min·m2),이보장혈관내용량화심장부하적최가화조절.
According to the hemodynamic changes,circulatory failure is divided into "warm" shock and "cold" shock,and severe circulatory failure often co-exist in both conditions in children.Circulatory failure in children is characterized by rapid change on hemodynamic status,pathologic vasodilation,relative or absolute hypovolemia,myocardial depression,altered blood flow distribution,and metabolic disorders.Therapeutic strategies include improving cardiac output and tissue perfusion,achieving SVO2>70% and cardiac index to 3.3~6.0 L/( min· m2 ),ensuring the intravascular blood volume and cardiac load.