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第三间隙异常是危重失血性中期休克的主要病理转归。这时,除失血外大量的功能性细胞外液被转移隔离在第三间隙,使血液浓缩,组织灌注循环功能衰竭,即使快速输注全血补足失血量,也不能恢复组织灌流,并不能逆转休克。近年来,我们应用10%氯化钠静脉推注抢救危重植入性胎盘及宫外孕大出血休克各1例,取得显著疗效。例1,女,23岁。患者于1小时前经阴道顺产1男婴后流血不止。经宫底注射催产素,静脉滴注催产素无效。神志朦胧20分钟而紧急送本院妇产科。查体:体温36℃,血压、脉搏测不出,呼吸22次/min,表情淡漠,意识模糊,生理反射迟钝。两肺呼吸音正常。心音弱,心率速122次/min,心律齐,无杂音。腹
The third gap anomalies is the main pathological outcome of critical hemorrhagic shock. At this time, in addition to blood loss outside a large number of functional extracellular fluid is transferred to the third gap in isolation, so that blood concentration, tissue perfusion circulation failure, even if rapid infusion of whole blood to make up for blood loss, can not restore tissue perfusion and can not be reversed shock. In recent years, we applied 10% sodium chloride intravenous injection rescue of critically implanted placenta and ectopic pregnancy hemorrhage shock in 1 case, and achieved significant results. Example 1, female, 23 years old. The patient bleeds more than 1 hour after vaginal birth 1 baby boy. Oxytocin injection through the end of the palace, intravenous infusion of oxytocin invalid. Ambiguous 20 minutes and sent to our hospital obstetrics and gynecology emergency. Physical examination: body temperature 36 ℃, blood pressure, pulse can not be measured, breathing 22 times / min, expression indifference, confusion, physical retardation. Breath sounds normal both lungs. Heart sounds weak, heart rate 122 times / min, rhythm Qi, no noise. belly