中国实用儿科杂志

中国实用儿科杂志 ›› 2024, Vol. 39 ›› Issue (9): 695-699.DOI: 10.19538/j.ek2024090610

• 专题笔谈 • 上一篇    下一篇

儿童脓毒性休克的渗漏综合征干预策略

  

  1. 吉林大学第一医院儿童医院儿童重症科，吉林  长春  130021
  • 出版日期:2024-09-06 发布日期:2024-09-24
  • 通讯作者: 李玉梅，电子信箱：liyumei1988@126.com

Intervention strategy for capillary leak syndrome due to pediatric septic shock

  1. Department of Pediatric Intensive Care Unit， Children's Medical Center， the First Hospital of Jilin University， Changchun 130021，China
  • Online:2024-09-06 Published:2024-09-24

摘要： 毛细血管渗漏综合征是由于各种原因造成毛细血管通透性增加，血管内液体渗漏到血管外，导致血管内血容量减少、血管外组织水肿，严重时可引起组织低灌注。脓毒性休克是引起毛细血管渗漏的原因之一，脓毒性休克后可出现或加重毛细血管渗漏，二者可形成恶性循环，增加患儿死亡风险。脓毒性休克的渗漏综合征干预策略包括两部分，一是脓毒性休克的快速根本治疗，二是针对渗漏的综合治疗，包括液体管理、控制炎症反应、改善血管内皮功能、中药治疗和对症支持治疗。明晰脓毒性休克引起渗漏的机制，采取有效的干预措施才能显著改善患儿的临床结局。

关键词: 儿童, 脓毒性休克, 毛细血管渗漏综合征, 干预策略

Abstract: Capillary leak syndrome is caused by the increased capillary permeability due to various reasons， and fluid shift from the intravascular to the extravascular space， resulting in intravascular hypovolemia， extravascular tissue edema ， and hypoperfusion in severe cases. Septic shock is one of the causes of capillary leak syndrome. After septic shock， capillary leak syndrome may occur or worsen， which can form a vicious cycle and increase the risk of death in children. The intervention strategy for capillary leak syndrome due to pediatric septic shock consists of two parts： one is rapid and radical treatment for septic shock， and the other is comprehensive treatment for capillary leak syndrome， including fluid management， control of inflammatory response， improvement of vascular endothelial function， and traditional Chinese medicine and supportive therapy.Clarifying the mechanism of capillary leak syndrome caused by septic shock and taking effective interventions can significantly improve the clinical outcomes of children.

Key words: child, septic shock, capillary leak syndrome, intervention strategy