Rossaint Jan, Margraf Andreas
Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland.
Anaesthesist. 2021 Jan;70(1):83-92. doi: 10.1007/s00101-020-00886-4.
The immune system is an effective defense against invading pathogens and is accompanied by recruitment of immune cells and initiation of an inflammatory reaction. This can also be triggered by noninfectious stimuli, e.g. a large surgical intervention and cause severe tissue destruction and organ dysfunction. The organism cannot distinguish many stimuli that are released during a large surgical intervention from exogenous pathogens. Therefore, there is a high risk for the occurrence of systemic inflammatory reactions, particularly in large surgical interventions. This excessive immune response leads to release of proinflammatory cytokines, endothelial dysfunction, damage to the glycocalyx, activation of leukocytes as well as tissue and organ destruction. This article summarizes the molecular principles of the surgery-associated inflammatory reaction, the differentiation from other inflammatory complications and treatment options.
免疫系统是抵御入侵病原体的有效防御机制，同时伴随着免疫细胞的募集和炎症反应的启动。这也可由非感染性刺激引发，例如大型外科手术干预，并导致严重的组织破坏和器官功能障碍。机体无法区分大型外科手术期间释放的许多刺激与外源性病原体。因此，发生全身炎症反应的风险很高，尤其是在大型外科手术中。这种过度的免疫反应会导致促炎细胞因子的释放、内皮功能障碍、糖萼损伤、白细胞激活以及组织和器官破坏。本文总结了手术相关炎症反应的分子原理、与其他炎症并发症的鉴别以及治疗选择。
