Su Heyi, Guo Zhenhui
Department of Geriatric Critical Care Medicine, Guangdong Provincial Key Laboratory of Geriatric Infection and Organ Function Support, Guangzhou Key Laboratory of Geriatric Infection and Organ Function Support, General Hospital of Guangzhou Military Command, Guangzhou 510010, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2017 Dec 25;20(12):1444-1447.
So far, there is still lack of effective treatment to control persistent inflammation immunosuppression catabolism syndrome (PICS) appeared generally in those chronic critical illnesses (CCI) patients, restricted by the development of medicine and scientific research nowadays. Because the uncontrolled PICS aggravates continuously, ICU stay of the CCI patients has been obviously prolonging and the late mortality elevates greatly. So exploring effective therapeutic strategies is obviously pressing. With the characteristics in PICS such as that elderly with sepsis or severe trauma tops the list of morbidity, progressing illness is difficult to intervent and various pathology changes occur simultaneously, the fundamental principle of treatment, "Focal screening, early control, joint intervention" must be followed. As for the specific intervention, lessoning from some diseases with immune and metabolic disorders to take "anabolic nutrition support", is a research focus presently as well as a considerably potential breakthrough at the treatment research in the future. This review retrospects a series of therapeutic strategies of PICS, such as immunity, metabolism regulation, nutrition support, glucose control and physiotherapy, in the purpose of laying the foundation of the development of joint intervention strategy for PICS.
目前，受当今医学和科研发展的限制，对于慢性危重病（CCI）患者普遍出现的持续性炎症免疫抑制分解代谢综合征（PICS），仍缺乏有效的治疗方法来加以控制。由于未得到控制的PICS持续恶化，CCI患者在重症监护病房（ICU）的住院时间明显延长，晚期死亡率大幅上升。因此，探索有效的治疗策略迫在眉睫。鉴于PICS具有如老年脓毒症或严重创伤发病率居首、病情进展难以干预且多种病理变化同时发生等特点，必须遵循“重点筛查、早期控制、联合干预”这一治疗基本原则。至于具体干预措施，借鉴一些免疫和代谢紊乱疾病的经验采取“合成代谢营养支持”，是目前的研究重点，也是未来治疗研究中颇具潜力的突破点。本综述回顾了PICS的一系列治疗策略，如免疫调节、代谢调控、营养支持、血糖控制和物理治疗等，旨在为PICS联合干预策略的发展奠定基础。
