第三间隙包括腹腔(腹水)、胸腔(胸腔积液)、肠腔内间隙、滑膜以及眼球前房。只要上述各个腔室间的体液循环得以保证,则体液与其中的同位素示踪剂就可以保持平衡。
非功能性细胞外液占体重的2%,包括横贯细胞液、结缔组织水、潴留的组织间液、关节液等,又称“第三间隙”(third space)的液体。手术创伤和很多外科疾病都可使非功能性细胞外液大量增加。
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病理性液体蓄积(或第三间隙损失):液体在损伤组织中积蓄量很少,在择期手术中通常无需考虑。
Pathological fluid accumulations (or anatomical third space losses) : The fluid accumulation in traumatized tissue is very small and needs usually no consideration in elective surgery.
第三间隙可能造成继发性并发症,例如间隔症候群,这时密闭的解剖学腔隙内肿胀;间隔症候群经常需要进行筋膜切开术。
Third spacing may lead to secondary complications such as compartment syndrome, which is swelling within a closed anatomical space; compartment syndrome often requires fasciotomy.
出现大量第三间隙,在最初 24 小时内需要补充许多流质;48 小时内,患者可能在受压部位隔离(第三间隙)>12 升流质
Massive third spacing occurs, requiring considerable fluid replacement in the first 24 hours; Patients may sequester (third space) more than 12 L of fluid in the crushed area over a 48-hour period
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