脓毒症诊断标准变迁及热点问题探讨  

Change in diagnostic criteria and hotspot issue of sepsis

作　　者：黄勋[1] 吴安华[1] HUANG Xun;WU An-hua(Center for Healthcare-associated Infection Control,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院感染控制中心

出　　处：《中国感染控制杂志》2019年第6期461-464,共4页Chinese Journal of Infection Control

基　　金：中南大学临床大数据项目基金(2013-79);中南大学湘雅医院临床科研基金(2013-11);脓毒症临床与实验室大数据系统的建立与完善(2014/01-2019/12)

摘　　要：近年来,脓毒症概念和诊断标准不断更新,是优化脓毒症临床诊治的必然要求,但同时给临床实践带来了新的挑战。本文回顾性分析脓毒症1.0、2.0、3.0三个版本中诊断标准的变迁情况,发现已发布的脓毒症指南中相关定义,无论国内外均存在不同程度不足。过去三十年,相关定义不断改变,不同的文献资料可能采用不同版本的定义,易引起对脓毒症认识及其数据上的混淆,可能导致临床脓毒症延误治疗或盲目扩大治疗。脓毒症诊断标准及流行病学数据仍需进一步探索和完善,中国也需要考虑设定容易测量,且有利于明确患者诊断及管理的推荐意见。The definition and diagnostic criteria of sepsis are constantly updated in recent years, which is an inevitable requirement for optimizing clinical diagnosis and treatment of sepsis, but it brings new challenges to clinical practice at the same time. This paper retrospectively reviews the changes in diagnostic criteria in sepsis 1.0, 2.0 and 3.0 version, and finds that relevant definitions in sepsis guidelines published at home and abroad are insufficient in varying degrees. Over the past three decades, definitions have been changing constantly, different versions of definitions may be adopted in different literatures, which is easy to cause confusion in sepsis knowledge and data, and may result in delayed treatment or blindly expand treatment of clinical sepsis. Diagnostic criteria and epidemiological data of sepsis still need to be further explored and improved, China also needs to consider formulating a series of recommendations that are easy to be measured and conducive to defining patient diagnosis and management.

关 键 词：脓毒症 诊断标准 感染 脓毒性休克 脓血症 

分 类 号：R631.2[医药卫生—外科学] R459.7[医药卫生—临床医学]