<h3>液體復蘇是解決危重患者血容量不足或休克的首要治療措施，但補液量過度會引起肺水腫；補液量不足則引起組織氧合障礙，引起腎血管收縮（以保障重要臟器灌注）從而引發(fā)腎功能損傷。<br></h3> <section class="" data-mpa-template-id="2460" data-mpa-color="#ffffff" data-mpa-category="標題" style="max-width: 100%; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; word-wrap: break-word !important;"><section data-id="91322" class="" data-color="#fda100" style="max-width: 100%; border-width: 0px; border-style: none; border-color: initial; word-wrap: break-word !important;"><section data-role="paragraph" style="max-width: 100%; border-width: 0px; border-style: none; border-color: initial; word-wrap: break-word !important;"><section style="padding: 10px; max-width: 100%; word-wrap: break-word !important;"><section data-width="100%" style="max-width: 100%; width: 360px; text-align: center; word-wrap: break-word !important;"><p style="margin-right: 16px; margin-left: 16px; max-width: 100%; clear: both; min-height: 1em; font-size: 18px; color: rgb(85, 85, 85); line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; color: rgb(253, 161, 0); word-wrap: break-word !important;"><strong style="max-width: 100%; word-wrap: break-word !important;">量出為入</strong><br style="max-width: 100%; word-wrap: break-word !important;"></span></h3><section style="margin-right: auto; margin-left: auto; max-width: 100%; width: 180px; word-wrap: break-word !important;"></section></section></section></section></section><p style="max-width: 100%; clear: both; min-height: 1em; word-wrap: break-word !important;"><br style="max-width: 100%; word-wrap: break-word !important;"></h3></section><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;">人體內(nèi)的體液通過以下幾種途徑排出體外。</span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;"><strong style="max-width: 100%; word-wrap: break-word !important;">1. 腎臟排尿：</strong>每日尿量一般約為 1000-1500 ml，至少 500 ml。每日人體代謝產(chǎn)生 35-40 g 固體廢物，而每 15 ml 尿能排出 1 g 固體廢物。</span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;"><strong style="max-width: 100%; word-wrap: break-word !important;">2. 經(jīng)肺呼出：</strong>正常情況下，每日經(jīng)過呼氣而喪失的水分約 400 ml。這種水分的喪失也是恒定的，不因體內(nèi)缺水而減少。</span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;"><strong style="max-width: 100%; word-wrap: break-word !important;">3. 經(jīng)皮膚丟失：</strong>每日從皮膚蒸發(fā)的體液約 500 ml。這種蒸發(fā)也是比較恒定的，也不因為體內(nèi)缺水而減少。<span style="max-width: 100%; line-height: 1.8; word-wrap: break-word !important;">如有出汗，則從皮膚的丟失會更多，而如有發(fā)熱，則體溫每升高 1 ℃，經(jīng)皮丟失的體液將增加 100 ml。</span></span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;"><strong style="max-width: 100%; word-wrap: break-word !important;">4. 經(jīng)消化道丟失：</strong>胃腸道每日分泌消化液約 8200 ml，其中絕大部分被重吸收，只有約 100 ml 從糞便排出。</span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;">以上通過各種途徑排出或丟失的體液總量約為 2000-2500 ml。其中皮膚蒸發(fā)（出汗除外）和經(jīng)肺呼出一般是看不到的，所以稱作不顯性失水。<span style="max-width: 100%; line-height: 1.8; word-wrap: break-word !important;">這些水份主要來自飲水 1000-1500 ml 和攝入的固態(tài)或半固態(tài)食物所含的水份。體內(nèi)氧化過程中生成的水份（內(nèi)生水）約 200-400 ml。</span></span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; line-height: 1.8; letter-spacing: 0.5px; word-wrap: break-word !important;">正常人攝入的水份和排出的水份基本是相等的，人體每日排出的水量就是需要的水量，約 2000-2500 ml。對于重癥患者而言，一個不能進食的成人如果沒有水的額外丟失，除去內(nèi)生水，2000 ml 就是最低生理需要量。</span></h3> <section class="" data-mpa-template-id="2460" data-mpa-color="#ffffff" data-mpa-category="標題" style="max-width: 100%; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; word-wrap: break-word !important;"><section data-id="91322" class="" data-color="#fda100" style="max-width: 100%; border-width: 0px; border-style: none; border-color: initial; word-wrap: break-word !important;"><section data-role="paragraph" style="max-width: 100%; border-width: 0px; border-style: none; border-color: initial; word-wrap: break-word !important;"><section style="padding: 10px; max-width: 100%; word-wrap: break-word !important;"><section data-width="100%" style="max-width: 100%; width: 360px; text-align: center; word-wrap: break-word !important;"><p style="margin-right: 16px; margin-left: 16px; max-width: 100%; clear: both; min-height: 1em; font-size: 18px; color: rgb(85, 85, 85); line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; color: rgb(253, 161, 0); word-wrap: break-word !important;"><strong style="max-width: 100%; word-wrap: break-word !important;">制定補液計劃</strong><br style="max-width: 100%; word-wrap: break-word !important;"></span></h3><section style="margin-right: auto; margin-left: auto; max-width: 100%; width: 180px; word-wrap: break-word !important;"></section></section></section></section></section><p style="max-width: 100%; clear: both; min-height: 1em; word-wrap: break-word !important;"><br style="max-width: 100%; word-wrap: break-word !important;"></h3></section><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;"><strong style="max-width: 100%; word-wrap: break-word !important;">1. 量出為入：</strong>患者在就診前的失水量一般是根據(jù)患者的脫水表現(xiàn)進行估計的，不很準確?；颊呔驮\后，應準確測量并記錄失水量，以后的的繼續(xù)失水量就應該按照記錄的失水量進行補充，丟失多少，補充多少。</span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;"><strong style="max-width: 100%; word-wrap: break-word !important;">2. 補什么？</strong></span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; line-height: 1.8; letter-spacing: 0.5px; word-wrap: break-word !important;">根據(jù)患者的實際情況選用：</span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; line-height: 1.8; letter-spacing: 0.5px; word-wrap: break-word !important;">（1）體液常用：血制品、血漿、右旋糖酐、聚明膠肽等；0.9% 氯化鈉注射液、葡萄糖氯化鈉注射液等；<br style="max-width: 100%; word-wrap: break-word !important;"></span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; line-height: 1.8; letter-spacing: 0.5px; word-wrap: break-word !important;">（2）補充熱量常用：10%葡萄糖注射液等；<br style="max-width: 100%; word-wrap: break-word !important;"></span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; line-height: 1.8; letter-spacing: 0.5px; word-wrap: break-word !important;">（3）功能性液體糾正酸中毒常用：5% 碳酸氫鈉或 11.2% 乳酸鈉等。<br style="max-width: 100%; word-wrap: break-word !important;"></span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;"><strong style="max-width: 100%; word-wrap: break-word !important;">3. 怎么補？</strong></span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;">具體補液方法如下：</span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;">（1）補液程序：先擴容（先用晶體液后用膠體液），然后調(diào)整電解質(zhì)和酸堿平衡；</span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;">（2）補液速度：先快后慢，通常 60 滴/分，相當于 250 ml/h。<span style="max-width: 100%; line-height: 1.8; word-wrap: break-word !important;">需注意的是，心、腦、腎功能障礙者補液應慢，補鉀時速度應慢；搶救休克時速度應快，應用甘露醇脫水時速度應快。</span></span></h3> <section class="" data-mpa-template-id="2460" data-mpa-color="#ffffff" data-mpa-category="標題" style="max-width: 100%; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; word-wrap: break-word !important;"><section data-id="91322" class="" data-color="#fda100" style="max-width: 100%; border-width: 0px; border-style: none; border-color: initial; word-wrap: break-word !important;"><section data-role="paragraph" style="max-width: 100%; border-width: 0px; border-style: none; border-color: initial; word-wrap: break-word !important;"><section style="padding: 10px; max-width: 100%; word-wrap: break-word !important;"><section data-width="100%" style="max-width: 100%; width: 360px; text-align: center; word-wrap: break-word !important;"><p style="margin-right: 16px; margin-left: 16px; max-width: 100%; clear: both; min-height: 1em; font-size: 18px; color: rgb(85, 85, 85); line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; color: rgb(253, 161, 0); word-wrap: break-word !important;"><strong style="max-width: 100%; word-wrap: break-word !important;">補充液體的順序</strong><br style="max-width: 100%; word-wrap: break-word !important;"></span></h3><section style="margin-right: auto; margin-left: auto; max-width: 100%; width: 180px; word-wrap: break-word !important;"></section></section></section></section></section><p style="max-width: 100%; clear: both; min-height: 1em; word-wrap: break-word !important;"><br style="max-width: 100%; word-wrap: break-word !important;"></h3></section><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;">總體原則：「先鹽后糖，見尿補鉀」。</span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;">體液的丟失主要是胃腸液、血或血漿，而這些液體是等滲的，因此，為了恢復血容量，就應當用等滲的液體來補充。<span style="max-width: 100%; line-height: 1.8; word-wrap: break-word !important;">葡萄糖注射液雖然也是等滲的（10% 葡萄糖是高滲的），但進入體內(nèi)后迅速被代謝為二氧化碳和水，達不到恢復血容量的目的。</span></span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;">脫水患者的鉀的總量不足，但在缺水的情況下，血液濃縮，患者的血鉀不一定降低；再額外補鉀甚至可能使血鉀升高，引發(fā)高鉀血癥。因此，只有患者尿量達到 40 ml/h 以上時，補鉀才是安全的。</span></h3> <section class="" data-mpa-template-id="2460" data-mpa-color="#ffffff" data-mpa-category="標題" style="max-width: 100%; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; word-wrap: break-word !important;"><section data-id="91322" class="" data-color="#fda100" style="max-width: 100%; border-width: 0px; border-style: none; border-color: initial; word-wrap: break-word !important;"><section data-role="paragraph" style="max-width: 100%; border-width: 0px; border-style: none; border-color: initial; word-wrap: break-word !important;"><section style="padding: 10px; max-width: 100%; word-wrap: break-word !important;"><section data-width="100%" style="max-width: 100%; width: 360px; text-align: center; word-wrap: break-word !important;"><p style="margin-right: 16px; margin-left: 16px; max-width: 100%; clear: both; min-height: 1em; font-size: 18px; color: rgb(85, 85, 85); line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(253, 161, 0); letter-spacing: 0.5px; word-wrap: break-word !important;"><strong style="max-width: 100%; word-wrap: break-word !important;">安全補液的監(jiān)護指標</strong></span></h3><section style="margin-right: auto; margin-left: auto; max-width: 100%; width: 180px; word-wrap: break-word !important;"></section></section></section></section></section><p style="max-width: 100%; clear: both; min-height: 1em; word-wrap: break-word !important;"><br style="max-width: 100%; word-wrap: break-word !important;"></h3></section><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;"><strong style="max-width: 100%; word-wrap: break-word !important;">1. 頸靜脈充盈程度：</strong>平臥時頸靜脈充盈不明顯，表示血容量不足；若充盈明顯甚至稱怒張狀態(tài)，表示心功能不全或補液過多。</span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;"><strong style="max-width: 100%; word-wrap: break-word !important;">2. 脈搏：</strong>血容量減少會導致心率加快，補液后脈搏逐漸恢復正常，表示補液適當；若脈搏變快變?nèi)?，則預示病情加重或發(fā)生心功能不全。</span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;"><strong style="max-width: 100%; word-wrap: break-word !important;">3. 中心靜脈壓（CVP）：</strong>CVP 是指右心房及上下腔靜脈胸腔段的壓力。它可反映患者血容量、心功能與血管張力的綜合情況。</span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;">CVP 的正常值為 5-12 cm H2O。其一般與血壓聯(lián)合動態(tài)觀察，存在以下幾種情況：</span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;">（1）CVP 和血壓同時降低，表示血容量嚴重不足，需要加快補液；</span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;">（2）CVP 降低而血壓正常，表示血容量不足，需要適當補液；</span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;">（3）CVP 增高而血壓降低則表示心功能不全或血容量相對過多，應減慢補液并給予強心藥物；</span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;">（4）CVP 增高而血壓正常表示容量血管過度收縮，需要使用舒張血管的藥物；</span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;">（5）CVP 正常而血壓降低，則表示血容量不足或心功能不全，應做補液試驗，即 10 min 內(nèi)靜脈注入生理鹽水 250 ml，若血壓升高而 CVP 不變，則為血容量不足，若血壓不變而 CVP 升高，則提示患者存在心功能不全。</span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;"><strong style="max-width: 100%; word-wrap: break-word !important;">4. 尿量：</strong>患者尿量是比較直觀的指標，尿量正常表示補液適當。</span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;"><strong style="max-width: 100%; word-wrap: break-word !important;">5. 血乳酸：</strong>血乳酸是休克早期最敏感的指標，血乳酸高于 2 mmol/L 稱為高乳酸血癥，高于 4 mmol/L 即為乳酸酸中毒，血容量不足會導致血乳酸升高，因此血乳酸也是反映血容量的一個指標之一。</span></h3> <section class="" data-mpa-template-id="2460" data-mpa-color="#ffffff" data-mpa-category="標題" style="max-width: 100%; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; word-wrap: break-word !important;"><section data-id="91322" class="" data-color="#fda100" style="max-width: 100%; border-width: 0px; border-style: none; border-color: initial; word-wrap: break-word !important;"><section data-role="paragraph" style="max-width: 100%; border-width: 0px; border-style: none; border-color: initial; word-wrap: break-word !important;"><section style="padding: 10px; max-width: 100%; word-wrap: break-word !important;"><section data-width="100%" style="max-width: 100%; width: 360px; text-align: center; word-wrap: break-word !important;"><p style="margin-right: 16px; margin-left: 16px; max-width: 100%; clear: both; min-height: 1em; font-size: 18px; color: rgb(85, 85, 85); line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;"><strong style="max-width: 100%; word-wrap: break-word !important;"><span style="max-width: 100%; color: rgb(253, 161, 0); word-wrap: break-word !important;">PICCO 補液</span></strong><br style="max-width: 100%; word-wrap: break-word !important;"></span></h3><section style="margin-right: auto; margin-left: auto; max-width: 100%; width: 180px; word-wrap: break-word !important;"></section></section></section></section></section><p style="max-width: 100%; clear: both; min-height: 1em; word-wrap: break-word !important;"><br style="max-width: 100%; word-wrap: break-word !important;"></h3></section><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;">PICCO（pulse contour cardiac output）技術是經(jīng)肺熱稀釋技術和脈搏波型輪廓分析技術的綜合，用于進一步的血液動力監(jiān)測和容量管理。</span></h3><p style="margin: 5px 16px; padding-bottom: 25px; max-width: 100%; clear: both; min-height: 1em; color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; font-size: 16px; letter-spacing: 0.544px; text-align: justify; white-space: normal; line-height: 1.75em; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0.5px; word-wrap: break-word !important;">近十年來，PICCO 被認為可以作為預測心臟前負荷及液體反應的良好檢測方法。通過 PICCO 監(jiān)測指導補液量可以應用于重癥肺部感染、重型顱腦損傷、肺水腫、ARDS、感染性休克、急性左心衰等等患者的液體管理，尤其適用于需要補液卻合并心功能不全的患者。</span></h3> <h3><font color="#b04fbb"><u>健康血液 致專致遠</u></font></h3>