拯救脓毒症新理念:从现象到本质

发布时间：2018-04-03 02:34

本文选题：脓毒症　切入点：EGDT　出处：《四川大学学报(医学版)》2016年04期

【摘要】：脓毒症是困扰重症医学界多年的临床综合征,近年国际上的几项大型研究对脓毒症治疗中的重要措施——早期目标导向治疗(early goal directed therapy,EGDT)方案提出质疑,脓毒症指南工作组对原有的集束化治疗(Bundle)也进行了修定,其本质在于强调通过多种方法实现对患者器官功能的全面评估,通过多元的措施达到监测与指导治疗的目的。随着对脓毒症发病机制的不断研究,大家已认识到脓毒症的核心机制并不能简单归咎于全身炎症反应,而是机体对抗感染的反应失调而引起的危及生命的器官功能损害,这促使了脓毒症定义的更新。脓毒症新定义将器官功能放到核心的位置,并强调了动态监测的重要性,对未来的临床与科研工作具有新的指导意义。关注多种监测方法的进展,并开展相应的临床和基础研究,才能为患者提供更好的综合治疗,达到改善患者生存和预后的目的。
[Abstract]:Sepsis is a clinical syndrome that has plagued the severe medical profession for many years. In recent years, several large researches in the world have questioned the early goal directed therapy (early goal directed therapy) scheme, which is an important measure in the treatment of sepsis.The working group on sepsis guidelines has also revised the original cluster therapy (bundle), the essence of which is to emphasize the comprehensive evaluation of patients' organ function through various methods, and the purpose of monitoring and guiding treatment through multiple measures.With the continuous study of the pathogenesis of sepsis, it has been recognized that the core mechanism of sepsis cannot simply be attributed to systemic inflammatory reactions, but rather to life-threatening organ dysfunction caused by the body's dysfunctional response to infection.This has prompted an update of the definition of sepsis.The new definition of sepsis puts organ function at the core, and emphasizes the importance of dynamic monitoring, which has a new guiding significance for clinical and scientific research in the future.Only by paying attention to the progress of various monitoring methods and carrying out corresponding clinical and basic research can we provide better comprehensive treatment for patients and improve the survival and prognosis of patients.
【作者单位】：四川大学华西医院重症医学科;
【基金】：国家卫生计生委医药卫生科技发展研究中心专项课题(No.WH2015-01-01)资助
【分类号】：R459.7

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