四. 结论<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /> 尽管人们对于脓毒症的自然病程和发生脓毒症的危险因素已经有了比较深刻的认识,但是在ICU的实际工作中监测单个脓毒症病人病情从一个阶段向另一个阶段发展仍有相当的难度,原因在于人们对与其终归相关临床指标或评估系统尚无统一认识。本研究通过对脓毒症的探索,发现生存和死亡病人在许多指标方面存在着差异,这种差异的累积,不仅有可能在决定病人的终归,也可能反映出脓毒症与其它急危重症不同的一面。因此,这些指标的发现,为早期了解脓毒症的可能预后和对疗效的评估提供了帮助。 参考文献 1.Ziegler HW. Molecular mechanism in tolerance to lipopolysaccharide. J Inflamm, 1995, 45(1): 13-26 2.Bone RC, Sibbald WJ, Sprung CL. The ACCP/SCCM consensus conference on sepsis and organ failure. Chest,1992,101(6): 1481 3.Shoemaker WC, Parsa MH. Invasive and noninvasive physiologic monitoring. In: Ayres SM, Grenvik A, Holbrook PR, et al. ed. Textbook of critical care. 3rd Edition, Philadelphia, 1995,252-266 4.Knaus WA, Harrell FE Jr, LaBrecque JF, et al. Use of predicted risk of mortality to evaluate the efficacy of anticytokine therapy in sepsis: The rhIL-1ra Phase III Sepsis Syndrome Study Group. Crit Care Med, 1996,24(1): 46-56 5.Rangel Frausto MS, Wenzel RP. The Epidemiology and Natural History of Bacterial Sepsis. In: Fein AM, Abraham EM, Balk RA, et al. ed. Sepsis and Multiple Organ Failure. Willians & Wilkin, 1997,27-42 6.Piper RD, Sibbald WJ. Multiple organ dysfunction syndrome, the relevance of persistent infection and inflammation. In: Fein AM, Abraham EM, Balk RA, et al. ed. Sepsis and Multiple Organ Failure. Willians & Wilkin, 1997, 190-201. 7.Brun Buisson C, Doyon F, Carlet J, et al. Incidence, risk factors, and outcome of severe sepsis and septic shock in adults A multicenter prospective study in intensive care units French ICU Group for Severe Sepsis. JAMA, 1995,274(12): 968-74 8.Eisele B, Lamy M. Clinical experience with antithrombin-III concentrates in critically ill patients with sepsis and multiple organ failure. Semin Thromb Hemost, 1998,24(1):71-80 9.林洪远. 多脏器功能衰竭综合征. 见: 刘大为主编. 21世纪医师丛书/危重病学分册 -- 北京:中国协和医科大学出版社, 2000.1, 51-69 |