重视脓毒症的早期诊断与临床干预

• 作 者: 白祥军 唐朝晖
• 机 构: 华中科技大学同济医学院附属同济医院创伤外科,
• 出 处: 临床急诊杂志
• 发表日期: 2006年05期
• 关键词: 脓毒症 早期诊断 临床干预

脓毒症(Sepsis)是严重创伤、大面积烧伤、休克、重度感染等临床急危重患者的严重并发症。脓毒症具有综合征的特点,其发生、发展,与感染、炎症、免疫和凝血系统功能改变等因素有密切的关系,具有复杂的病理生理机制,并易引起 SIRS、MODS 等严重并发症,且病情进展迅速,病死率高。在美国,脓毒症的发病率为300例/10万/年,每年约有75万人患脓毒症,22.5万人死亡。治疗费用惊人,每年达167亿美元之巨。在德国脓毒症的发病率约为116例/10万/年。在巴西的 ICU,脓毒症、重症脓毒症、脓毒症休克的发病率分别为61.4例/1000人/日、35.6例/1000人/日和30.0例/1000人/日,死亡率分别为34.7%、47.3%和52.2%。脓毒症的临床救治工作极为困难,而早期识别、及时诊断、早期综合干预治疗是有效防治脓毒症发生、发展及提高救治成功率的关键。

Sepsis is a serious complication in critically ill patients with severe trauma, extensive burns, shock and severe infections. Sepsis has the characteristics of syndrome, its occurrence, development, and infection, inflammation, immune and coagulation system function changes and other factors are closely related, with complex pathophysiological mechanisms, and easily lead to SIRS, MODS and other serious complications, And the rapid progress of the disease, high mortality. In the United States, the incidence of sepsis is 300 cases / 100 000 / year, about 750 000 people suffering from sepsis and 225000 deaths each year. The cost of treatment is staggering, reaching $ 16.7 billion annually. The incidence of sepsis in Germany is about 116 cases / 100,000. In the ICU in Brazil, the rates of sepsis, severe sepsis and septic shock were 61.4 deaths per 1000 person-days, 35.6 deaths per 1000 person-days and 30.0 deaths per 1000 person-days, respectively 34.7%, 47.3% and 52.2% respectively. Clinical treatment of sepsis is extremely difficult, but early identification, timely diagnosis and treatment of early comprehensive intervention is the key to effective prevention and treatment of sepsis, development and improve the success rate of treatment.