摘要
脓毒症是导致患者入住重症监护病房(ICU)的主要病因之一。虽脓毒症及脓毒性休克的诊疗已取得了一定的进展,但其病死率仍居高不下。欧洲重症监护医学会和美国重症医学会(ESICM/SCCM)于2021年10月发布了最新的拯救脓毒症运动(SSC)指南,对脓毒症相关的诊疗规范做了更新。在脓毒症及脓毒性休克筛查方面,不推荐将快速序贯器官衰竭评分(qSOFA)作为单一的筛查工具。同时细化了感染诊断、控制及抗菌药物使用方面的建议内容,包含对疑似脓毒症患者进行持续性评估、不推荐联合使用降钙素原(PCT)来评估抗菌药物的启动时机、新增了抗真菌治疗建议,并对β-内酰胺类药物的输注方式进行了规范。此外,对一些新的治疗技术与理念用于脓毒症患者的诊疗价值也进行了建议和推荐。本文对照2016年SSC脓毒症指南,对2021年SSC脓毒症指南的重点内容进行解读,以期帮助国内医疗人员更好管理和救治脓毒症及脓毒性休克患者。
Sepsis is one of the major contributing factors to the ICU admission.Despite significant advances have been made in the diagnosis and treatment of sepsis,the mortality rate remains persistently high.The European Society of Intensive Care Medicine and the Society of Critical Care Medicine(ESICM/SCCM)published a new Surviving Sepsis Campaign(2021 SSC)guideline in October 2021,and updated some related diagnosis and treatment recommendations.2021 SSC guideline did not recommend using quick sequential organ failure score(qSOFA)as a single screening tool for sepsis and septic shock.Furthermore,this guideline refines the recommendations for infectious diagnosis,control and antibiotic therapy,including continuous evaluation of patients with suspected sepsis,against using procalcitonin to guide antimicrobial initiation in clinical evaluation,anti-fungal treatment recommendations,and the standardized ofβ-lactam infusion.In addition,some new treatment techniques and concepts are also recommended for the diagnosis and treatment of sepsis patients.In order to assist Chinese physicians achieved a better treatment and management of patients with sepsis and septic shock,this present paper interpreted the 2021 SSC guideline and compared it with 2016 SSC guideline.
作者
孙啸宇
陆宗庆
张金
肖文艳
华天凤
杨旻
Sun Xiaoyu;Lu Zongqing;Zhang Jin;Xiao Wenyan;Hua Tianfeng;Yang Min(The Second Department of Intensive Care Unit,the Laboratory of Cardiopulmonary Resuscitation and Critical Care Medicine,the Second Hospital of Anhui Medical University,Hefei 230601,Anhui,China)
出处
《中国中西医结合急救杂志》
CAS
CSCD
北大核心
2021年第6期645-652,共8页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
国家自然科学基金(82072134)
国家自然科学基金青年基金(81601661)。
作者简介
通讯作者:杨旻,Email:512130761@qq.com。
