脓毒症治疗的现状与新进展

Current Situation and New Progress of Sepsis Treatment

脓毒症是感染导致的以全身炎性反应综合征为特征的临床综合征,是创伤、烧伤、休克、感染等临床急危重患者的严重并发症之一,也是诱发脓毒性休克、多器官功能障碍综合征的重要原因。近年来,尽管对脓毒症的认识不断加深、脓毒症指南不断更新、早期诊断水平的提高以及医护技术与医疗设备的改善,脓毒症的发生和死亡状况却并未明显改善,其已成为危重病领域关注的重要问题和急救医学研究的热点。在脓毒症的集束化治疗中,抗生素、液体复苏、机械通气等治疗措施的疗效相对肯定,但在糖皮质激素、血糖控制、肾脏代替等方面的应用一直存在争议。

Sepsis,a clinical syndrome characterized by systemic inflammatory response syndrome causedby infection, is one of the serious complications of acute and critically ill patients with trauma, bum, shock,infection, and is also an important cause of septic shock and multiple organ dysfunction syndrome. In recentyears, despite the deepening of understanding of sepsis, constantly updating of sepsis guidelines, continuousimprovement of the early diagnosis level, medical technology and medical equipment, the occurrence of sepsisand mortality has not improved significantly, which has become an important issue in the field of criticalillness and a hotspot in research of emergency medicine. In the bundle treatment of sepsis, antibiotics, fluidresuscitation, mechanical ventilation get relative certain effect, while controversies always exist in the applica-tion of glucocorticoid, blood sugar control, and renal replacement therapy.