摘要
脓毒性休克是脓毒症最严重的一种疾病状态,常合并明显的循环或细胞代谢异常,死亡率高达40%以上。微循环功能障碍是脓毒性休克发生发展的关键环节。外周微循环灌注不足是最易识别的临床表现之一,毛细血管再充盈时间(capillary refill time,CRT)作为一种简单易行的床边评估外周微循环的方式,很早就应用于临床,近年来又重新得到重视,并被2021年拯救脓毒症运动指南推荐应用。本篇综述主要从CRT的测量方法、在脓毒性休克中的意义、局限性及多模式灌注评估几个方面,阐述CRT在脓毒性休克中的应用进展,旨在提高大家对CRT的认识,规范CRT的临床应用,提高CRT的临床应用效果,以期改善脓毒性休克患者预后。
Septic shock is a more severe disease state of sepsis,often combined with significant circulatory or cellular metabolic abnormalities,with a mortality rate of 40%or more.Microcirculatory dysfunction is a key component in the development of septic shock.Inadequate perfusion of the peripheral microcirculation is one of the most readily detectable clinical manifestations,and capillary refill time(CRT),a simple and easy bedside assessment of peripheral microcirculation,has been used clinically for a long time,has gained renewed attention in recent years,and is recommended for application by the 2021 Surviving sepsis campaign guidelines.This review focuses on the application advances of CRT in septic shock in terms of its measurement method,significance in septic shock,limitations,and multimodal perfusion monitoring,aiming to improve the understanding of CRT,standardize the clinical application of CRT,and improve the clinical application of CRT with the aim of improving the prognosis of patients in septic shock.
作者
游进进
左祥荣
You Jinjin;Zuo Xiangrong(Department of Critical Care Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing,China)
基金
江苏省“333高层次人才培养工程”项目(项目编号:[2022]3-25-045)
江苏省青年医学人才项目(项目编号:QNRC2016557)
江苏省高层次卫生人才“六个一工程”拔尖人才科研项目(项目编号:LGY2019067)
关键词
毛细血管再充盈时间
脓毒性休克
微循环障碍
多模式灌注评估
Capillary refill time
Septic shock
Microcirculation abnormalities
Multimodal perfusion monitoring
作者简介
通信作者:左祥荣,E-mail:zuoxiangrong@njmu.edu.cn
