感染性休克血管活性药物选择策略

Strategy for selection of vasoactive drugs in treatment of patients with septic shock

在重症监护病房(ICU)中,管理严重感染和感染性休克患者是重症医生日常工作,因为感染性休克是ICU患者死亡的主要原因。应用血管活性药物是治疗感染性休克重要的循环支持手段。近年来,血管活性药物的应用和疗效在不断进行重新评价。2012年《严重感染和感染性休克国际治疗指南》以及2014年《中国严重脓毒症/脓毒性休克治疗指南》进一步就感染性休克患者血管活性药物的应用提出了推荐性的意见,值得临床医师重视。

Management of patients with severe sepsis and septic shock is almost a daily exercise in most intensive care units, because septic shock may be the leading cause of death in ICUs. Unfortunately, despite all the efforts expended in this area, the mortality in these conditions has changed little over the years. Applications of vasoactive drugs are important means to support circulation in patients with septic shock. In recent years, their applications and and efficacies were being evaluated constantly. Applications of vasoactive drugs are also recommended by International Guidelines for Management of Severe Sepsis and Septic Shock（2012） and Chinese Guidelines for Management of Severe Sepsis and Septic Shock（2014）, which should be paid attention to by clinical doctors.