脓毒症患者毛细血管渗漏综合征的危险因素分析  

Analysis of Clinical Risk Factors for Capillary Leak Syndrome in Sepsis Patients

作　　者：翟建华[1] 卢斌[1] 刘晨燕[1] 高玉雷[1] 寿松涛[1] ZHAI Jianhua;LU Bin;LIU Chenyan;GAO Yulei;SHOU Songtao(Emergency Department,General Hospital of Tianjin MedicalUniversity,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院急诊医学科

出　　处：《继续医学教育》2019年第5期85-87,共3页Continuing Medical Education

摘　　要：脓毒症是一种高患病率、高死亡率、高治疗费用的临床综合征,是危重病研究的热点和难点。毛细血管渗漏综合征(capillary leak syndrome,CLS)发病机制是因毛细血管内皮细胞损伤,血管通透性增加而引起毛细血管水肿,大量血浆蛋白渗透到组织间隙,从而出现低蛋白血症、低血容量休克、急性肾缺血等临床表现。部分脓毒症患者在病情恶化或治疗过程中出现低血压、低氧血症、低灌注、低蛋白、低血容量、少或无尿、全身水肿、多器官功能障碍综合征(MODS)等表现--即CLS,是疾病最凶险、最严重、最复杂的表现,并发症多,治疗矛盾多,直接影响患者的预后。脓毒症合并CLS,是否及时诊断及有效治疗将影响患者的预后。因此对脓毒症合并CLS的临床危险因素进行分析,以期改善脓毒症患者的预后,降低死亡率。Sepsis is a clinical syndrome with high morbidity, high mortality and high cost of treatment, it is the hot and difficult problem in critical diseases. The pathogenesis of capillary leak syndrome(CLS) is the injury of capillary endothelial cell and the increased vascular permeability which caused the capillary edema. A large number of plasma protein penetrate into the tissue gap, resulting in hypoalbuminemia, hypovolemic shock,acute renal ischemia and other clinical manifestations. Some patients with sepsis in the process of deterioration or treatment appear low blood pressure, hypoxemia, hypoperfusion, hypoalbuminemia, hypovolemia,oliguria or anuria, anasarca, MODS and other performances - that is CLS.It is the most dangerous, the most serious, the most complex performance situation with more complications and more contradictions in treatment, it will directly influence the prognosis of patients. Whether we can diagnose sepsis with CLS timely and whether we can treat the patients perfectly will influence the prognosis. Therefore, this article will analyze the clinical risk factors of sepsis with CLS in order to improve the prognosis of patients and reduce the mortality rate.

关 键 词：脓毒症 毛细血管渗漏综合征 血管通透性水肿 临床危险因素 预后 

分 类 号：R459.7[医药卫生—急诊医学]