CAJ | 학술논문

背景严重脓毒症(脓毒症伴有器官功能障碍、灌注不良或低血压)和脓毒性休克(严重脓毒症患者给予足量液体复苏仍无法纠正持续性低血压)对于全世界围术期患者来说都是严重而致命的问题. 目的目前普遍认为及时施加适当的干预将改善其预后.通过对相关文献进行系统综述,希望能为临床医师提供有价值的参考意见. 内容针对严重脓毒症和脓毒性休克的管理,主要围绕以下方面:抗感染、容量治疗、机械通气、血糖控制、预治并发症等. 趋向脓毒症的病理机制涉及炎症、凝血、凋亡3方面功能失调.当前对于治疗策略的研究也着重围绕这3个核心问题开展.尽管指南在不断地定期更新,但对患者预后影响的报道还十分有限.这就需要我们共同协作,积极开展多中心科研工作,不断验证和完善指南,为临床工作带来更多提高.
배경 엄중농독증(농독증반유기관공능장애、관주불량혹저혈압)화농독성휴극(엄중농독증환자급여족량액체복소잉무법규정지속성저혈압)대우전세계위술기환자래설도시엄중이치명적문제. 목적 목전보편인위급시시가괄당적간예장개선기예후.통과대상관문헌진행계통종술,희망능위림상의사제공유개치적삼고의견. 내용 침대엄중농독증화농독성휴극적관리,주요위요이하방면:항감염、용량치료、궤계통기、혈당공제、예치병발증등. 추향 농독증적병리궤제섭급염증、응혈、조망3방면공능실조.당전대우치료책략적연구야착중위요저3개핵심문제개전.진관지남재불단지정기경신,단대환자예후영향적보도환십분유한.저취수요아문공동협작,적겁개전다중심과연공작,불단험증화완선지남,위림상공작대래경다제고.
Background Severe sepsis (acute organ dysfunction secondary to infection) and septic shock (severe sepsis combined with hypotension which can not be reversed by fluid resuscitation) are critical and life-threatening problems for perioperative patients around the world.Objective It is widely acknowledged that,appropriate treatments administered in time are likely to influence the outcome.This present article is aimed to draw a systemic review of the relevant literature to provide a valuable reference for clinicians.Content Contemporary achievements in management of severe sepsis and septic shock were mainly focused on:anti-infection,goal-directed volume therapy,mechanical ventilation,glycemic control,prophylaxis and treatment of complications etc.Trend The pathogenesis of sepsis including inflammation,coagulation dysfunction and apoptosis.The research on novel theraputic strategies,is based on the three important aspects mentioned above.Although the guidelines have been updating on a regular basis,documents related to the impact on prognosis are still quite limited.This requires us to launch multicenter research,to validate and complete the protocols,and to make more contributions to clinical practice.