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Sepsis与感染性休克的治疗:争议中前行

康焰

康焰. Sepsis与感染性休克的治疗:争议中前行[J]. 协和医学杂志, 2018, 9(5): 421-425. doi: 10.3969/j.issn.1674-9081.2018.05.009
引用本文: 康焰. Sepsis与感染性休克的治疗:争议中前行[J]. 协和医学杂志, 2018, 9(5): 421-425. doi: 10.3969/j.issn.1674-9081.2018.05.009
Yan KANG. Treatments of Sepsis and Septic Shock: Advancements in Controversy[J]. Medical Journal of Peking Union Medical College Hospital, 2018, 9(5): 421-425. doi: 10.3969/j.issn.1674-9081.2018.05.009
Citation: Yan KANG. Treatments of Sepsis and Septic Shock: Advancements in Controversy[J]. Medical Journal of Peking Union Medical College Hospital, 2018, 9(5): 421-425. doi: 10.3969/j.issn.1674-9081.2018.05.009

Sepsis与感染性休克的治疗:争议中前行

doi: 10.3969/j.issn.1674-9081.2018.05.009
详细信息
    作者简介:

    康焰:电话:028-85422739,E-mail:kangyan@scu.edu.cn

  • 中图分类号: R441.9

Treatments of Sepsis and Septic Shock: Advancements in Controversy

More Information
  • 摘要: Sepsis和感染性休克是导致重症患者死亡的主要原因之一。随着对Sepsis病理生理机制和临床诊治研究的逐渐深入,“拯救Sepsis运动(Surviving Sepsis Campaign,SSC)”自2004年起每4年对SSC指南更新一次,使临床诊疗逐渐趋于规范。近10余年的数据显示,Sepsis患者的病死率稳定且呈显著下降趋势。2016年更新的SSC指南在抗感染治疗方面遭遇到了美国感染病学会(Infectious Disease Society of America,IDSA)的挑战,其在官方期刊Clin Infect Dis发表公开立场声明,不再支持SSC指南。这一举动给临床医生借鉴和应用2016年版SSC指南带来很大困惑。深入了解两大学会对于SSC指南争议的本质至关重要,只有回归争议本质,理清分歧的基点,才能更好地使用指南,使其真正成为临床诊治Sepsis和感染性休克的重要参考。
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    [2] IDSA Sepsis Task Force. Infectious Diseases Society of America (IDSA) Position Statement: Why IDSA Did Not Endorse the Surviving Sepsis Campaign Guidelines[J]. Clin Infect Dis, 2018, 66:1631-1635. doi:  10.1093/cid/cix997
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    [7] Uzzan B, Cohen R, Nicolas P, et al.Procalcitonin as a diagnostic test for sepsis in critically ill adults and after surgery or trauma: a systematic review and meta-analysis[J]. Crit Care Med, 2006, 34: 1996-2003. doi:  10.1097/01.CCM.0000226413.54364.36
    [8] Giamarellos-Bourboulis EJ, Grecka P, Poulakou G, et al. Assessment of procalcitonin as a diagnostic marker of underlying infection in patients with febrile neutropenia[J]. Clin Infect Dis, 2001, 32: 1718-1725. doi:  10.1086/320744
    [9] Petrikkos GL, Christofilopoulou SA, Tentolouris NK, et al. Value of measuring serum procalcitonin, C-reactive protein, and mannan antigens to distinguish fungal from bacterial infections[J]. Eur J Clin Microbiol Infect Dis, 2005, 24: 272-275. doi:  10.1007/s10096-005-1312-z
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    [12] de Jong E, van Oers JA, Beishuizen A, et al. Efficacy and safety of procalcitonin guidance in reducing the duration of antibiotic treatment in critically ill patients: a randomised, controlled, open-label trial[J]. Lancet Infect Dis, 2016, 16: 819-827. doi:  10.1016/S1473-3099(16)00053-0
    [13] Jekarl DW, Lee SY, Lee J, et al. Procalcitonin as a diagnostic marker and IL-6 as a prognostic marker for sepsis[J].Diagn Microbiol Infect Dis, 2013, 75:342-347. doi:  10.1016/j.diagmicrobio.2012.12.011
    [14] Mustafić S, Brkić S, Prnjavorac B, et al. Diagnostic and prognostic value of procalcitonin in patients with sepsis[J].Med Glas (Zenica), 2018, 15:93-100. doi:  10.1016/j.ijid.2008.05.1301
    [15] Miglietta F, Faneschi ML, Lobreglio G, et al.Procalcitonin, C-reactive protein and serum lactate dehydrogenase in the diagnosis of bacterial sepsis, SIRS and systemic candidiasis[J].Infez Med, 2015, 23:230-237. http://cn.bing.com/academic/profile?id=7cc492c30159b04e586aecee13a0b17c&encoded=0&v=paper_preview&mkt=zh-cn
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出版历程
  • 收稿日期:  2018-07-04
  • 刊出日期:  2018-09-30

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