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| 題 名 | 敗血症引起急性腎損傷的診斷與治療=Diagnosis and Treatment of Infection Induced Acute Kidney Injury |
|---|---|
| 作 者 | 陳俊全; 歐世祥; 周康茹; | 書刊名 | 內科學誌 |
| 卷 期 | 36:2 2025.04[民114.04] |
| 頁 次 | 頁125-135 |
| 分類號 | 415.81 |
| 關鍵詞 | 敗血症; 急性腎損傷; 輸液灌注; 腎臟替代治療; 血液灌流療法; Sepsis; Acute kidney injury; Fluid resuscitation; Renal replacement therapy; Hemoperfusion; |
| 語 文 | 中文(Chinese) |
| DOI | 10.6314/JIMT.202504_36(2).04 |
| 中文摘要 | 敗血症引起急性腎損傷(SI-AKI)在重症患者中非常常見,並顯著增加患者的併發症和死 亡率。其發生和進展的原因涉及多種複雜的病理生理因素。SI-AKI的風險與適當的治療有 關,因此及時診斷與治療至關重要。SI-AKI基本的治療策略包括給予適當的抗生素、輸液復 甦和必要時使用血管升壓劑。嚴重AKI病人,則需要腎臟替代治療(RRT)。關於SI-AKI輸液 復甦治療的劑量、種類、RRT啟動的時機,內毒素吸附或細胞激素移除的血液灌流療法以及 靜脈注射免疫球蛋白(IVIG)的腳色等,仍存在爭議與討論。本文將針對以上議題提出現有的 證據與建議,期能減輕SI-AKI的醫療負擔並改善患者預後。 |
| 英文摘要 | Sepsis-induced acute kidney injury (SI-AKI) is a common complication in critically ill patients, significantly contributing to increased morbidity and mortality. The development and progression of SI- AKI are driven by a variety of complex pathophysiological factors, including alterations in macrocirculation and microcirculation, mitochondrial dysfunction, and metabolic reprogramming. The basic treatment strategy for SI- AKI includes the administration of appropriate antibiotics, fluid resuscitation, and vasopressors if needed. Patients with severe AKI may require renal replacement therapy (RRT). However, the optimal fluid therapy strategy for SI-AKI, including dosage, type of fluids, and timing of initiating RRT, as well as the roles of hemoperfusion for endotoxin adsorption or cytokine removal and intravenous immunoglobulin (IVIG), remain topics of debate and discussion. This article aims to present the current evidence and recommendations on these issues, with the goal of reducing the medical burden of SI-AKI and improving patient outcomes. |
本系統中英文摘要資訊取自各篇刊載內容。