中国实用儿科杂志

中国实用儿科杂志 ›› 2024, Vol. 39 ›› Issue (9): 669-673.DOI: 10.19538/j.ek2024090605

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基于病理生理学的儿童脓毒性休克的救治

  

  1. 复旦大学附属儿科医院重症医学科，上海  201102
  • 出版日期:2024-09-06 发布日期:2024-09-23
  • 通讯作者: 陆国平，电子信箱：13788904150@163.com
  • 基金资助:
    国家重点研发计划（2021YFC2701800，2021YFC2701802，2021YFC2701805）；上海市卫生健康系统重点扶持学科项目（2023ZDFC0103）

Treatment for children with septic shock based on pathophysiology

  1. Department of Critical Care Medicine， Children’s Hospital of Fudan University， Shanghai  201102，China
  • Online:2024-09-06 Published:2024-09-23

摘要： 脓毒症是宿主对感染反应失调导致危及生命的器官功能障碍，其病理生理学复杂，主要涉及机制包括免疫失衡、微循环障碍以及线粒体功能障碍。脓毒性休克是脓毒症合并心血管功能障碍，是造成危重症儿童高死亡率的病因之一。文章总结了基于病理生理学予以儿童脓毒性休克的救治要点，包括控制感染，免疫调节，改善微循环及线粒体功能等措施，有助于临床医师对儿童脓毒性休克治疗的理解。

关键词: 脓毒性休克, 感染, 免疫, 微循环, 线粒体

Abstract: Sepsis is a dysregulated host response to infection leading to life-threatening organ dysfunction with a complex pathophysiology that involves major mechanisms including immune imbalance， microcirculatory disorders， and mitochondrial dysfunction. Septic shock， a combination of sepsis with cardiovascular dysfunction， is one of the etiologic factors contributing to high mortality in critically ill children. This article summarizes the key points of treatment of septic shock in children based on pathophysiology， including infection control， immunomodulation， and improvement of microcirculation and mitochondrial function， which will help clinicians understand the treatment of septic shock in children.

Key words: septic shock, infection, immune, microcirculation, mitochondria