血液微循环监测在脓毒性休克患者救治中的应用价值及现实问题

Application value of blood microcirculation monitoring in the treatment of patients with septic shock

微循环遍布全身各脏器与组织,是与组织直接接触的循环要素,在营养输送、代谢和废物清除中发挥关键作用。然而,在脓毒性休克中,由于内皮功能障碍、血细胞流变学改变及凝血功能紊乱等引起的微循环障碍能影响血流与组织需求的匹配,是导致器官功能障碍的重要病理机制。且脓毒性休克患者常常存在微循环和宏观循环之间的“脱耦联”现象。近年来,微循环监测在脓毒性休克患者血流动力学支持治疗中倍受关注,本文仅对血液微循环监测在脓毒性休克患者救治中的应用价值及现实问题做一综述。

Microcirculation is distributed in all the organs and tissues of the body,which is a circulatory element in direct contact with tissues and plays a key role in nutrient transport,metabolism and waste removal.However,in septic shock,microcirculation disorders caused by endothelial dysfunction,blood cell rheology and coagulation dysfunction affect the matching of blood flow and tissue demand,which is an important pathological mechanism leading to organ dysfunction.And septic shock often exists the phenomenon of"decoupling"between microcirculation and macrocirculation.In recent years,microcirculation monitoring has attracted more and more attention in hemodynamic support treatment of patients with septic shock.This article only reviews the application value and practical problems of microcirculation monitoring in the treatment of patients with septic shock.