如何根据临床指南进行个体化治疗--从脓毒症与感染性休克治疗国际指南说起

How to Implement Personalized Therapy According to Clinical Guidelines:From International Guidelines for Management of Sepsis and Septic Shock

脓毒症一直是全球死亡的主要原因。基于循证医学证据的脓毒症治疗指南推动了全球对脓毒症的认知,持续强化了医务人员对脓毒症发生发展的理解,不断规范临床治疗,为临床医疗行为标准的建立提供了依据,是“个体化”治疗实施的前提。当面对患者个体时,指南推荐意见不能完全代替临床医生的决策能力,所有诊疗决策需根据患者自身的病理生理特点进行定量干预。本文通过对2021年版《拯救脓毒症运动:脓毒症与感染性休克治疗国际指南》推荐意见进行分析,浅谈“个体化”治疗与指南之间的相关性,如何在临床干预中坚持“目标与目的”“连续与动态”“治疗与再损伤”三大原则,如何根据指南进行“个体化”治疗。

Sepsis is a major cause of death world wide. Evidence-based SSC guidelines promoted the global medical staffs’ awareness of sepsis and septic shock, strengthened the understanding of the occurrence and development, and provided a common ground for all clinicians. SSC guidelines are the premise of implementing “personalized”therapy, but management that strictly adheres to guidelines may not necessarily be the best option for each patient.Personalized management needs quantitative intervention according to the patient’s pathophysiological characteristics and individual response. In this article, we will describe the correlation between “personalized” therapy and guidelines through the recommendations of 2021 SSC guidelines, and expound on how to implement personalized therapy according to clinical guidelines.