引用本文:刘双林,李 琦.重症社区获得性肺炎的集束化治疗难点分析[J].中国临床新医学,2020,13(1):11-15.
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重症社区获得性肺炎的集束化治疗难点分析
刘双林,李 琦
400037 重庆,陆军军医大学第二附属医院呼吸与危重症医学中心
摘要:
[摘要] 重症社区获得性肺炎起病急,进展迅猛,往往表现为严重和持久的低氧血症,甚至出现急性呼吸窘迫综合征,同时也易并发严重的血流动力学异常出现循环衰竭,甚至出现多系统器官功能障碍,导致其病死率增高。其最常见的病原体仍为肺炎链球菌,而病毒、非典型病原体尤其是军团菌在致病原中的地位逐渐显现。将合并不同表现(如脓毒症休克、急性呼吸窘迫综合征)的重症社区获得性肺炎按照循证医学证据进行集束化、标准化、流程化治疗,有助于改善患者预后,可有效降低重症肺炎患者的病死率。
关键词:  重症社区获得性肺炎  集束化治疗  脓毒症休克  急性呼吸窘迫综合征
DOI:10.3969/j.issn.1674-3806.2020.01.03
分类号:R 563.1
基金项目:
Analysis of the difficulties in bundled treatment of severe community-acquired pneumonia
LIU Shuang-lin, LI Qi
Center of Pulmonary and Critical Care Medicine, the Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
Abstract:
[Abstract] Severe community-acquired pneumonia(SCAP) has an acute onset and rapid progress, often manifested as severe and persistent hypoxemia, even acute respiratory distress syndrome(ARDS), and is also prone to severe hemodynamic abnormalities and circulatory failure, and even multiple system organ dysfunction, resulting in increased mortality. Streptococcus pneumoniae is still the most common pathogen of SCAP, and the roles of viruses, atypical pathogens, especially Legionella in the pathogens are gradually emerging. SCAP with different manifestations such as septic shock and ARDS will be performed bundled, standardized and flow-based treatment according to evidence-based medical evidence, which will help to improve the prognosis of the patients and may effectively reduce the mortality of the patients with severe pneumonia.
Key words:  Severe community-acquired pneumonia(SCAP)  Bundled treatment  Septic shock  Acute respiratory distress syndrome(ARDS)