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烧伤后脓毒症的诊断与综合治疗

[Diagnosis and comprehensive management of sepsis after burn].

作者信息

Chai Jia-ke

机构信息

Burns Institute, the First Hospital Affiliated to the PLA General Hospital, Beijing 100048, China.

出版信息

Zhonghua Shao Shang Za Zhi. 2013 Apr;29(2):105-8.

Abstract

Sepsis induced by invasive infection is a challenging problem and the major cause of death after severe burn. With the increasing understanding of sepsis, diagnostic criteria of sepsis were proposed and revised consecutively so that they could be consistent with the clinical practice. Being different from other trauma and critical diseases, diagnostic criteria of sepsis after severe burn were also proposed, and they need further clinical verification. It is believed that comprehensive measures for the treatment of severe sepsis after burn should be advocated. These measures include rapid and effective resuscitation of burn shock, early escharotomy and closure of burn wound, metabolic support, immunoregulation and anti-inflammation, reinforcement of organ support, etc. Although a number of advances have been achieved in the past decades, the mechanism of sepsis need further elucidation, diagnostic criteria of sepsis need further revision, and novel therapeutic measures for burn sepsis should be developed.

摘要

侵袭性感染所致脓毒症是一个具有挑战性的问题,也是严重烧伤后主要的死亡原因。随着对脓毒症认识的不断深入,脓毒症的诊断标准相继被提出并修订,以使其与临床实践相符。与其他创伤及危重病不同,严重烧伤后脓毒症的诊断标准也已提出,尚需进一步的临床验证。人们认为应提倡针对烧伤后严重脓毒症的综合治疗措施。这些措施包括迅速有效地复苏烧伤休克、早期切痂及封闭烧伤创面、代谢支持、免疫调节与抗炎、加强器官支持等。尽管在过去几十年里已取得了许多进展,但脓毒症的发病机制仍需进一步阐明,脓毒症的诊断标准需进一步修订,且应研发针对烧伤脓毒症的新型治疗措施。

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