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《非创伤性出血的急诊处理专家共识/意见》解读

刘红升,  赵晓东

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文章导航 > 协和医学杂志  > 2018 >  9(2): 150-153
刘红升, 赵晓东. 《非创伤性出血的急诊处理专家共识/意见》解读[J]. 协和医学杂志, 2018, 9(2): 150-153. doi: 10.3969/j.issn.1674-9081.2018.02.009
引用本文: 刘红升, 赵晓东. 《非创伤性出血的急诊处理专家共识/意见》解读[J]. 协和医学杂志, 2018, 9(2): 150-153. doi: 10.3969/j.issn.1674-9081.2018.02.009
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Hongsheng Liu, Xiaodong Zhao. Interpretation and Comments on Experts' Consensus/Opinion on the Emergency Treatment for Non-traumatic Hemorrhage[J]. Medical Journal of Peking Union Medical College Hospital, 2018, 9(2): 150-153. doi: 10.3969/j.issn.1674-9081.2018.02.009
Citation: Hongsheng Liu, Xiaodong Zhao. Interpretation and Comments on Experts' Consensus/Opinion on the Emergency Treatment for Non-traumatic Hemorrhage[J]. Medical Journal of Peking Union Medical College Hospital, 2018, 9(2): 150-153. doi: 10.3969/j.issn.1674-9081.2018.02.009
shu

《非创伤性出血的急诊处理专家共识/意见》解读

doi: 10.3969/j.issn.1674-9081.2018.02.009

  • 解放军总医院第一附属医院急救部，北京 100048

基金项目: 

国家杰出青年基金 30125020

详细信息
    通讯作者:

    赵晓东  电话：010-66867361, Email:zxd63715@126.com

  • 中图分类号: R459.7

Interpretation and Comments on Experts' Consensus/Opinion on the Emergency Treatment for Non-traumatic Hemorrhage

  • Department of Emergency, the First Affiliated Hospital of Chinese PLA General Hospital, Beijing 100048, China

More Information
    Corresponding author: ZHAO Xiao-dong   Tel: 010- 66867361. Email:zxd63715@126.com

    摘要
  • 摘要: 非创伤性出血是急诊最常见的急症之一，因其涉及面广、风险性高且救治要求协作性强，对急诊医师临床能力提出了更高要求。急诊医师协会非创伤出血急诊处理专家工作组从定义、分类、急诊临床管理策略和抗凝止血治疗等方面制定了《非创伤性出血的急诊处理专家共识/意见》。该共识/意见从急诊救治的临床实操出发，切实突出急诊救治的首要原则：优先保证基本生命体征平稳，然后再诊治具体出血原因。该共识还强调A(air，气道)、B(breath，呼吸)、C(circulation，循环)管理及评估与处置相结合的重要性，同时将临床医生较棘手的止、凝血治疗作了重点阐述。本文针对此版共识/意见的指导要点进行解读，以利于各科医师更全面深入掌握该类急症的处置方法，提高临床救治效率。
    Abstract: Non-traumatic hemorrhage, as one of the most common acute emergencies with a wide range, high risk, and multiple disciplines, requires emergency physicians to have a higher clinical ability. The first edition of Experts' Consensus/Opinion on the Emergency Treatment for Non-traumatic Hemorrhage was formulated in 2017 by Chinese College of Emergency Physician, which consists of definitions, classifications, clinical management strategies and emergency anticoagulation haemostatic treatment for patients with non-traumatic hemorrhage. Based on the clinical practice of emergency care, the consensus emphasizes life saving as the first priority. The principle is Firstly guarantee basic vital signs and then find out the source of bleeding and give pertinent treatments. The consensusalso emphasizes the importance of evaluation and management of air, breath, and circulation, as well as the importance of stopping the bleeding and coagulation for these patients. Based on the experts' consensus/opinion, this article focuses on interpretation so that physicians can grasp the emergency approach and methods more comprehensively to improve the efficiency of clinical treatment.
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    • 参考文献(20)
  • [1] Majeed A, Hwang HG, Eikelboom JW, et al. Effectiveness and outcome of managestrategies for dabigatran or warfarin related major bleeding events [J]. Throm Res, 2016, 140: 81-88. doi:  10.1016/j.thromres.2016.02.005
    [2] Price B, Arthur AO, Brunko M, et al. Hemodynamic consequences of ketamine vs etomidate for endotracheal intubation in the air medical setting [J]. Am J Emerg Med, 2013, 31:1124-1132. doi:  10.1016/j.ajem.2013.03.041
    [3] 刘业成, 杜铁宽, 朱华栋, 等.非创伤性出血的急诊处理专家共识/意见[J].中华急诊医学杂志, 2017, 26: 850-856. doi:  10.3760/cma.j.issn.1671-0282.2017.08.002
    [4] 马青变, 郑亚安, 葛洪霞, 等.急诊老年和非老年患者死亡原因比较研究[J].中国急救医学, 2013, 33: 1015-1020. doi:  10.3969/j.issn.1002-1949.2013.11.015
    [5] Gralnek IM, Dumonceau JM, Kuipers EJ, et al. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline[J].Endoscopy, 2015, 47:al-a46. http://gut.bmj.com/external-ref?access_num=10.1055/s-0034-1393172&link_type=DOI
    [6] Jensen DM, Eklund S, Persson T, et al. Reassessment of rebleeding risk of forrest IB (oozing) peptic ulcer bleeding in a large international randomized trial[J]. Am J Gastroenterol, 2017, 112:441-446. doi:  10.1038/ajg.2016.582
    [7] Abbasi S, Farsi D, Hafezimoghadam P, et al. Accuracy of emergency physician-performed ultrasound in detecting traumatic pneumothorax after a 2h training course[J]. Eur J Emerg Med, 2013, 20:173-177. doi:  10.1097/MEJ.0b013e328356f754
    [8] 赵晓东.创伤患者呼吸道管理策略-尽早气管管理, 过分谨慎就是失误[J].中华急诊医学杂志, 2015, 24:359-362. doi:  10.3760/cma.j.issn.1671-0282.2015.04.004
    [9] Shenoy AK, Ramesh KV, Chowta MN, et al. Effects of botropase on clotting factors in healthy human volunteers[J]. Perspect Clin Res, 2014, 5:71-74. doi:  10.4103/2229-3485.128024
    [10] 罗建方, 刘华东.2014年欧洲心脏病学会主动脉疾病诊治指南解读[J].岭南心血管病杂志, 2014, 20:691-696. doi:  10.3969/j.issn.1007-9688.2014.06.001
    [11] 中华医学会心血管病学分会.华法林抗凝治疗的中国专家共识[J].中华内科杂志, 2013, 52:76-82. doi:  10.3760/cma.j.issn.0578-1426.2013.01.027
    [12] 王兆钺, 李建琴, 曹丽娟, 等.长期使用蛇毒血凝酶致低纤维蛋白原血症三例:报告并文献复习[J].中华血液学杂志, 2014, 35:50-52. doi:  10.3760/cma.j.issn.0253-2727.2014.01.013
    [13] Nery F, Chevret S, Condat B, et al. Causes and consequences of portal vein thrombosis in 1, 243 patients with cirrhosis: results of a longitudinal study[J].Hepatology, 2015, 61: 660-667. doi:  10.1002/hep.27546
    [14] 柏愚, 李兆申.急性非静脉曲张性上消化道出血诊治-老问题, 新观念, 新指南, 新解读[J].胃肠病学, 2017, 22:449-451. doi:  10.3969/j.issn.1008-7125.2017.08.001
    [15] de Franchis R, BavenoVI Faculty.Expanding consensus in portal hypertension: report of the baveno VI consensus workshop: stratifying risk and individualizing care for portal hypertension[J].J Hepatol, 2015, 63: 743-752 doi:  10.1016/j.jhep.2015.05.022
    [16] Ghabril M, Agarwal S, Lacerda M, et al. Portal vein thrombosis is a risk factor for poor early outcomes after liver transplantation: analysis of risk factors and outcomes for portal vein thrombosis in waitlisted patients[J].Transplantation, 2016, 100: 126-133. doi:  10.1097/TP.0000000000000785
    [17] Gao PJ, Gao J, Li Z.et al. Liver transplantation in adults with portal vein thrombosis: Data from the China Liver Transplant Registry[J].Clin Res Hepatol Gastroenterol, 2016, 40: 327-332. doi:  10.1016/j.clinre.2015.05.010
    [18] Malone CD, Ramaswamy RS, Rose SC. Control of massive hemoptysis via a "black-door"approach through the pulmonary artery[J].Radiol Case Rep, 2016 11: 83-85. doi:  10.1016/j.radcr.2016.03.001
    [19] Berry K, Taylor J, Liou IW, et al. Portal vein thrombosis is not associated with increased mortality among patients with cirrhosis[J].Clin Gastroenterol Hepatol, 2015, 13: 585-593. doi:  10.1016/j.cgh.2014.10.010
    [20] Naeshiro N, Aikata H, Hyogo H, et al. Efficacy and safety of the anticoagulant drug, danaparoid sodium, in the treatment of portal vein thrombosis in patients with liver cirrhosis[J].Hepatol Res, 2015, 45: 656-662. doi:  10.1111/hepr.12400
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出版历程
  • 收稿日期:  2018-12-15
  • 刊出日期:  2018-03-30

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