Diagnosis and management of sepsis
Diagnosis and management of sepsis
复制标题
败血症的诊断和处理
DOI：
10.7861/clinmedicine.18-2-146
复制
发表时间：
2018-04-01
影响因子：
4.4
通讯作者：
Evans, Tom
中科院分区：
文献类型：
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作者：
Evans, Tom
脓毒症是一种常见的疾病，具有较高的发病率和死亡率。虽然许多患者可能需要重症监护，本文认为脓毒症的特点是最相关的急性全科医生。最近更新的脓毒症和脓毒性休克的定义已经提出，更好地识别可能有不良结局的患者，因此有机会加强护理。尽管取得了这些进展，但仍然没有能够诊断脓毒症的分子特征。发病机制复杂，涉及许多免疫和非免疫介质。四个关键领域是内皮功能障碍、凝血异常、细胞功能改变和心血管反应失调。针对脓毒症介质的特异性治疗尚未被证明是有效的。及时给予适当的抗生素以及液体复苏和氧气是有益的。
Sepsis is a common condition with high morbidity and mortality. Although many patients may require critical care, this article considers the features of sepsis that are of most relevance to acute general physicians. Recently updated definitions of sepsis and septic shock have been proposed which better identify patients who are likely to have a poor outcome, and therefore give an opportunity to escalate care. Despite these advances, there is still no molecular signature able to diagnose sepsis. Pathogenesis is complex, with many immune and non-immune mediators involved. Four key areas are endothelial dysfunction, coagulation abnormalities, alterations in cell function and dysregulated cardiovascular responses. No specific therapy targeting the mediators of sepsis has yet proven effective. Prompt administration of appropriate antibiotics is of benefit, together with fluid resuscitation and oxygen.