Beger H G, Oettinger W
Klinik f. Allgemeinchirurgie, Universität Ulm.
Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir. 1989:819-22.
A basic prerequisite of successful treatment of sepsis in intensive care patients is early recognition. Aside from the classic clinical signs of infection, minute changes in volume demand, respiratory need, kidney function and cardiovascular regulation may indicate a septic complication. The surgical/mech. elimination of septic foci is still the paramount therapeutic principle. Volume and respiratory therapy, hemofiltration, cardiovascular and antibiotic medication may add to the standard procedure of intensive care. Contact site inhibitors, mediator antagonists, and antibodies targeted against endotoxin, bacteria or leukocyte surface antigens are either still controversial or undergoing preclinical evaluation.
重症监护患者成功治疗脓毒症的一个基本前提是早期识别。除了感染的典型临床体征外,容量需求、呼吸需求、肾功能和心血管调节的细微变化可能提示脓毒症并发症。手术/机械清除脓毒症病灶仍然是首要的治疗原则。容量和呼吸治疗、血液滤过、心血管和抗生素用药可能会补充到重症监护的标准程序中。接触位点抑制剂、介质拮抗剂以及针对内毒素、细菌或白细胞表面抗原的抗体,要么仍存在争议,要么正在进行临床前评估。