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不要漏诊脓毒症!

Don't miss the diagnosis of sepsis!

作者信息

Marik Paul E

出版信息

Crit Care. 2014 Sep 27;18(5):529. doi: 10.1186/s13054-014-0529-6.

Abstract

The early detection and treatment of sepsis are the most important factors in improving the outcome of patients with this condition. However, many patients admitted to hospital experience a long delay in the diagnosis of sepsis. Furthermore, it is not uncommon for febrile patients to be sent home from the Emergency Department or the physician's office with the diagnosis of 'flu' only to return hours or days later in overt septic shock. The early diagnosis of sepsis may be challenging as many of the signs and symptoms are non-specific. Clinical studies suggest that early diagnosis of sepsis requires a high index of suspicion and comprehensive clinical evaluation together with laboratory tests, including a complete blood count with differential, lactate and procalcitonin levels.

摘要

脓毒症的早期检测和治疗是改善该病症患者预后的最重要因素。然而,许多住院患者在脓毒症诊断方面存在长时间延误。此外,发热患者从急诊科或医生办公室被诊断为“流感”后被送回家,数小时或数天后却因明显的感染性休克再次返回,这种情况并不罕见。由于许多体征和症状不具特异性,脓毒症的早期诊断可能具有挑战性。临床研究表明,脓毒症的早期诊断需要高度的怀疑指数、全面的临床评估以及实验室检查,包括全血细胞计数及分类、乳酸和降钙素原水平检测。

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