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癌症危重症患者感染并发症的诊断与治疗。

Diagnosis and management of infectious complications in critically ill patients with cancer.

机构信息

Critical Care Medicine Service, Department of Anesthesiology and Critical Care Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, C1179, New York, NY 10021, USA.

出版信息

Crit Care Clin. 2010 Jan;26(1):59-91. doi: 10.1016/j.ccc.2009.09.007.

Abstract

Cancer and its treatments lead to profound suppression of innate and acquired immune function. In this population, bacterial infections are common and may rapidly lead to overwhelming sepsis and death. Furthermore, infections caused by viral and fungal pathogens should be considered in patients who have specific immune defects. As cancer therapies have become more aggressive the risk for infection has increased and many patients require intensive care support. Despite improvements in long-term survival, infections remain a common complication of cancer therapy and accounts for the majority of chemotherapy-associated deaths. By understanding the host defense impairments and likely pathogens clinicians will be better able to guide diagnosis and management of this unique population.

摘要

癌症及其治疗会导致先天和获得性免疫功能的严重抑制。在这类人群中,细菌感染很常见,并可能迅速导致败血症和死亡。此外,具有特定免疫缺陷的患者还应考虑病毒和真菌病原体引起的感染。随着癌症治疗变得更加激进,感染的风险增加了,许多患者需要重症监护支持。尽管长期生存率有所提高,但感染仍然是癌症治疗的常见并发症,也是化疗相关死亡的主要原因。通过了解宿主防御功能障碍和可能的病原体,临床医生将能够更好地指导对这一特殊人群的诊断和治疗。

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