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頁籤選單縮合
題名 | 兒科病人的敗血性休克=Septic Shock-Rediatric Considerations |
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作者姓名(中文) | 林聖山; 孫麗娟; 王景甲; 吳恩婷; | 書刊名 | 中華民國重症醫學雜誌 |
卷期 | 7:2 民94 |
頁次 | 頁77-86 |
分類號 | 417.5159 |
關鍵詞 | 全身發炎性反應; 敗血症; 休克; 輸液治療; Systemic inflammatory response syndrome; Sepsis; Shock; Fluid resuscitation; |
語文 | 中文(Chinese) |
中文摘要 | 敗血症(Sepsis)包括各種嚴重程度的疾病。一般而言,是感染造成全身發炎性反應(SIRS),更嚴重是嚴重敗血症,最嚴重就是敗血性休克。兒科病人的SIRS定義包含心跳加速呼吸加快,但和成人的SIRS定義最大的不同是奶科病人的SIRS必須有體溫及白血球計數的異常,而不能只看心跳及呼吸次數。而心跳和呼吸次數的正常則和年齡有關,另外,關於器官功能失調也另有定義。關於治療方面,2003年由美國重症醫學會提出戰勝敗血症的活動(surviving sepsis campaign)及early goal-directed therapy以期降低敗血症的死亡率。而在兒科病人,敗血症初期治療的目標,和大人不同的地方在於血壓不是治療的目的。另外,積極輸液治療是存活的基礎,在PALS中有清楚的處理準則。另外,有些成人有效的藥物,在兒科病人的療效則不同。 |
英文摘要 | Sepsis is a disease of continuum. Generally speaking, it included infection-induced systemic inflammatory syndrome (SIRS), then severe sepsis, and septic shock as the most severe form. In pediatric patients, the definition of SIRS also included tachycardia and tachypnea. However, different from the definition in adult patients, both abnormalities in temperature and white blood cell count should be present in SIRS in pediatric patients. The normal value of heart rate and respiratory rate varies with ages; and organ dysfunction also has specific definitions in pediatric patients. As for treatment, society of critical care medicine has proposed “surviving sepsis campaign” and “early-goal directed therapy” since 2003 in order to decreased the mortality of sepsis. In pediatric patients, blood pressure itself is not the goal of treatment, which is different from adults. Besides, aggressive fluid resuscitation is the foundation of survival, which has been described as guidelines in PALS. Besides, the effect of some innovative drug which has been proved effective in adults with sepsis is still unclear to pediatric patients. |
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