战术区损伤控制复苏的进展及启发

宗兆文; 叶钊

doi:10.16016/j.1000-5404.201906051

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战术区损伤控制复苏的进展及启发

军事医学 | 更新时间：2026-01-09

- 战术区损伤控制复苏的进展及启发
- Tactical damage control resuscitation: definition, evolution, and proposals
- 第三军医大学学报 2019年41卷第24期页码：2361-2365
- 作者机构：
  
  1.400038 重庆，陆军军医大学(第三军医大学)陆军卫勤训练基地战救技能训练教研室
  2.400037 重庆，陆军军医大学(第三军医大学)第二附属医院骨科/急诊科
- 作者简介：
  
  [ 宗兆文，博士，主任医师/教授，博士生导师，主要从事战救技术和战救训练方面的研究。兼任中国医学救援协会创伤分会主委等学术职务，主持全军军事医学创新工程等十余项课题，主编《现代军医战伤救治培训教程》等7部专著。多次参加外军的战救技术培训和国际学术交流。先后获国家科技进步二等奖、重庆市科技进步一等奖、总后科技新星等学术奖励。E-mail:zongzhaowen@163.com ZONG Zhaowen, E-mail: zongzhaowen@163.com
- 基金信息：
  
  陆军军医大学新桥医院临床重大创新特色技术项目(2018JSLC0023);军事医学创新工程(16CXZ017)
- DOI：10.16016/j.1000-5404.201906051
  中图分类号： R826.1
- 收稿：2019-06-05，
  
  修回：2019-08-30，
  
  纸质出版：2019-12-30
- 稿件说明：
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宗兆文, 叶钊. 战术区损伤控制复苏的进展及启发[J]. 第三军医大学学报, 2019,41(24):2361-2365.

Zhaowen ZONG, Zhao YE. Tactical damage control resuscitation: definition, evolution, and proposals[J]. Journal of Third Military Medical University, 2019, 41(24): 2361-2365.
宗兆文, 叶钊. 战术区损伤控制复苏的进展及启发[J]. 第三军医大学学报, 2019,41(24):2361-2365. DOI： 10.16016/j.1000-5404.201906051.

Zhaowen ZONG, Zhao YE. Tactical damage control resuscitation: definition, evolution, and proposals[J]. Journal of Third Military Medical University, 2019, 41(24): 2361-2365. DOI： 10.16016/j.1000-5404.201906051.

摘要

战时有相当比例的伤员在被送到战地医院时就已经发生了急性创伤性凝血病(acute traumatic coagulopathy，ATC)和低体温，死亡率高。为降低由此导致的伤亡率，需要从战现场急救阶段就实施损伤控制复苏(tactical damage control resuscitation

TDCR)。TDCR近年的主要进展包括:(1)从预测大出血向预测创伤性凝血病转变，以尽早识别需要实施控制损伤复苏的伤员；(2)复苏策略从固定比例的成分输血向以纤维蛋白原浓缩物等为基础的、实验室指标指导下的精确复苏转变；(3)与复苏策略演变相适应，复苏制剂的选择也在不断演变中。这些进展对我军战现场急救的启发包括:在加强不同类型战伤的凝血病变化规律研究的基础上建立精确的战现场ATC预测体系，并加强TDCR技术的培训。

Abstract

Coagulopathy and hypothermia occur in a considerable percentage of combat casualties when they were transferred to combat support hospital and result in a high mortality. To reduce the mortality of combat casualties

tactical damage control resuscitation (TDCR) needs to be implemented as early as possible

preferentially in the first aid stage and early treatment stage. The strategies for TDCR have undergone evolutions

highlighted by the transition from prediction of massive transfusion to the prediction of acute traumatic coagulopathy (ATC)

by the transition from fixed ratio resuscitation with blood components to accurate resuscitation guided by laboratory examinations and concentrates-based hemostatic resuscitation

and by the evolution of the product options for resuscitation to keep up with the development of new resuscitation strategies. The advancement in TDCR urges greater efforts to enhance the research of the natural course of different combat injuries

to establish an accurate prediction system for ATC

and to enhance the training of TDCR skills.

关键词

Keywords

references

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