刘晶晶, 王小亭, 刘大为, 柴文昭. 重症医学科感控认知心路[J]. 协和医学杂志, 2024, 15(3): 479-482. DOI: 10.12290/xhyxzz.2024-0114
引用本文: 刘晶晶, 王小亭, 刘大为, 柴文昭. 重症医学科感控认知心路[J]. 协和医学杂志, 2024, 15(3): 479-482. DOI: 10.12290/xhyxzz.2024-0114
LIU Jingjing, WANG Xiaoting, LIU Dawei, CHAI Wenzhao. Cognitive Advances of Hospital Acquired Infection Prevention in the Department of Critical Care Medicine[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(3): 479-482. DOI: 10.12290/xhyxzz.2024-0114
Citation: LIU Jingjing, WANG Xiaoting, LIU Dawei, CHAI Wenzhao. Cognitive Advances of Hospital Acquired Infection Prevention in the Department of Critical Care Medicine[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(3): 479-482. DOI: 10.12290/xhyxzz.2024-0114

重症医学科感控认知心路

Cognitive Advances of Hospital Acquired Infection Prevention in the Department of Critical Care Medicine

  • 摘要: 重症医学科是医院感染较为集中的科室,而医院感染与重症患者的预后紧密相关。以医院感染为轴线,重症患者的救治可分为3个阶段:(1)原发疾病的处理和器官功能支持;(2)重症导致的各种并发症的治疗;(3)控制进一步损害及新发并发症。后2个阶段循环往复,可使患者进入持续炎症反应和高代谢状态,最终导致预后不良。通过各阶段感控措施的充分落实以降低医院感染风险是重症救治过程中不可忽视的组成部分。因此,如何理解、预防、治疗重症医学科的医院感染是重症医学发展的当务之急。本文从改变对医院感染的认知、规范具体防控措施、夯实理论基础、认识防控即治疗、整合治疗和质控5个方面综合阐述重症医学科医院感染的防治策略,最终形成以重症患者医院感染防控为基石的重症救治理念,实现降低重症患者医院感染风险,提高重症医学科医疗质量的目标。

     

    Abstract: The department of critical care medicine has a high prevalence of hospital acquired infections, which are closely associated with prognosis of critically ill patients. With hospital acquired infections as the axis, the treatment of critically ill patients can be divided into three phases: management of the primary disease and support of organ function, treatment of various complications resulting from the primary disease, and control of further damage and new complications. The cycle of the last two phases may put the patient in a state of Persistent inflammation, Immunosuppression, and Catabolism Syndrome (PICS), which ultimately leads to a poor prognosis. Fine control of the above three stages to reduce the risk of hospital acquired infections is a non-negligible component of the critical care process. Therefore, how to understand, prevent and treat hospital acquired infections is a top priority in the current development of critical care medicine. This review provides a comprehensive overview of strategies for the prevention and management of hospital acquired infections in critical care, covering five areas: changing the perception of hospital acquired infections, standardizing specific prevention interventions, consolidating the theoretical basis, recognizing that hospital acquired infection prevention are treatments, and integrating treatment to quality assurance. The aim is to develop the concept of severe treatment based on the prevention and control of severe patients, reduce the risk of hospital acquired infections of severe patients and improve the quality of critical care.

     

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