协和医学杂志

2018, v.9(05) 421-425

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Sepsis与感染性休克的治疗:争议中前行
Treatments of Sepsis and Septic Shock: Advancements in Controversy

康焰;
KANG Yan;Department of Critical Care Medicine,West China Hospital of Sichuan University;

摘要(Abstract):

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。
Sepsis and septic shock are among the leading causes of death in critically ill patients. Since considerable advances have been made in understanding their pathophysiology and clinical management,the Surviving Sepsis Campaign( SSC) guideline for sepsis and septic shock is updated every four years since 2004,which aims at standardizing the clinical practice. The mortality of sepsis was significantly decreased based on the data from the last decades. The recent update of SSC was released in 2016,but it was argued against by Infectious Disease Society of America( IDSA) regarding antimicrobial therapy. IDSA published a statement on its official journal,Clinical Infectious Diseases,claiming they did not endorse the SSC guideline,which caused some confusion in clinical references and applications. So it is important to understand the essence of the controversy between these two societies. The guidelines of SSC and IDSA can better instruct the clinical practice for sepsis and septic shock only after the core of the contradiction between them is fully understood.

关键词(KeyWords): Sepsis;休克;感染;治疗
sepsis;shock;infection;treatment

Abstract:

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作者(Author): 康焰;
KANG Yan;Department of Critical Care Medicine,West China Hospital of Sichuan University;

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