摘要
背景严重脓毒症（脓毒症伴有器官功能障碍、灌注不良或低血压）和脓毒性休克（严重脓毒症患者给予足量液体复苏仍无法纠正持续性低血压）对于全世界围术期患者来说都是严重而致命的问题。目的目前普遍认为及时施加适当的干预将改善其预后。通过对相关文献进行系统综述，希望能为临床医师提供有价值的参考意见。内容针对严重脓毒症和脓毒性休克的管理，主要围绕以下方面：抗感染、容量治疗、机械通气、血糖控制、预治并发症等。趋向脓毒症的病理机制涉及炎症、凝血、凋亡3方面功能失调。当前对于治疗策略的研究也着重围绕这3个核心问题开展。尽管指南在不断地定期更新，但对患者预后影响的报道还十分有限。这就需要我们共同协作，积极开展多中心科研工作，不断验证和完善指南，为临床工作带来更多提高。
Background Severe sepsis （acute organ dysfunction secondary to infection） and septic shock （severe sepsis combined with hypotension which can not be reversed by fluid resuscitation） are critical and life-threatening problems for perioperative patients around the world. Objective It is widely acknowledged that, appropriate treatments administered in time are likely to influence the outcome. This present article is aimed to draw a systemic review of the relevant literature to provide a valuable reference for clinicians. Content Contemporary achievements in management of severe sepsis and septic shock were mainly focused on： anti-infection, goal-directed volume therapy, mechanical ventilation, glycemic control, prophylaxis and treatment of complications etc. Trend The pathogenesis of sepsis including inflammation, coagulation dysfunction and apoptosis. The research on novel theraputic strategies, is based on the three important aspects mentioned above. Although the guidelines have been updating on a regular basis, documents related to the impact on prognosis are still quite limited. This requires us to launch multicenter research, to validate and complete the protocols, and to make more contributions to clinical practice.
出处
《国际麻醉学与复苏杂志》
CAS
2013年第11期1028-1032,共5页
International Journal of Anesthesiology and Resuscitation
关键词
脓毒症
严重脓毒症
脓毒性休克
全身炎症反应
Sepsis
Severe sepsis
Septic shock
Systemic inflammatory reaction syndrome
