严重创伤并发持续炎症-免疫抑制-分解代谢综合征的研究进展

Research progress of severe trauma complicated with persistent inflammation-immunosuppression-catabolism syndrome

持续炎症-免疫抑制-分解代谢综合征(PICS)是指遭受严重创伤等重大疾病打击的患者,经积极液体复苏及器官功能支持后免于早期死亡,进入慢性危重症阶段,发展为以持续性炎症、免疫抑制及蛋白质高分解代谢为特征的临床症候群,其防治困难、发病率逐年增高是导致严重创伤患者长期生活质量低下及远期死亡的重要原因,已成为重症创伤患者治疗的新挑战。但目前对PICS的认识及重视不足,本文就PICS的概念、临床特征、诊断、病理机制及治疗等多方面进行综述,旨在加深对PICS的认识,促进PICS的诊疗。

Persistent inflammation,immunosuppression and catabolism syndrome( PICS) refers to the patients suffering from serious trauma or other major diseases, who accepts active fluid resuscitation and organ function support in order to avoid early death,enters into the stage of chronic critical illness, and developed into a clinical syndrome characterized by persistent inflammation,immunosuppression and high protein catabolism. Its prevention and treatment are difficult and the incidence rate is increasing year by year,which is an important cause of long-term low quality of life and long-term death in the patients with severe trauma,and is a new challenge for the treatment of patients with severe trauma. This article reviews the concept,clinical features,diagnosis,pathological mechanism and treatment of PICS in order to deepen the understanding of PICS,promote the diagnosis and treatment of PICS,and finally improve the prognosis of severe trauma.