Abstract:

Consistency and controversy of the fluid therapy for surgical patients        REN Jian-an. Research Insitute of General Surgery，Nanjing General Hospital of Nanjing Military Command，PLA，Nanjing 210002，China
Abstract    The aims of fluid therapy include resuscitation，routine maintenance，replacement and redistribution. Initial assessment and monitoring should be performed before and after fluid therapy. If patients are receiving Ⅳ fluids for resuscitation，reassess the patient is necessary frequently. The choice of fluid comprised of sodium chloride glucose solution，albumin，Ringer’s solution，hydroxyethyl starch. Recommend human albumin solution for fluid resuscitation only in patients with severe sepsis. Damage control resuscitation should be considered when managing the severe trauma patients and whole blood or reconstituted blood is superior to the packed red blood cells. Surgeons should assess the patient’s likely fluid and electrolyte needs from their history，clinical examination，current medications，clinical monitoring and laboratory investigations before and during fluid therapy.

Key words: fluid therapy；normal saline；albumin；Ringer&rsquo, s solution；hydroxyethyl starch；damage control resuscitation

摘要：

液体治疗目的包括复苏、维持液体及电解质平衡，纠正液体失衡和异常分布。生理盐水是最早使用的晶体液，但其并不完全符合生理，又陆续产生了林格液、乳酸林格液和醋酸林格液等。在重症脓毒症病人复苏时推荐使用白蛋白溶液。在失血性休克复苏中，全血仍是最好的选择。液体治疗须对病人进行全面评估，包括病史、体检情况、目前用药情况、临床监测和实验室检查，由此决定病人液体和电解质需要量。复苏后再评估可确保后续液体治疗正确合理。对持续接受静脉液体治疗的病人须定期监测液体需要量、实验室指标、出入量和体重。

关键词: 液体治疗, 生理盐水, 林格液, 白蛋白, 羟乙基淀粉, 损伤控制性复苏