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改善败血症的康复:一篇综述
Hallie C Prescott1,2, Derek C Angus3,4
1Department of Internal Medicine and Institute for Healthcare Policy & Innovation, University of Michigan, Ann Arbor.
JAMA
|January 4, 2018
概括
败血症幸存者面临重大长期挑战,包括新的功能,认知和心理健康障碍. 医院后护理应解决这些问题,并监测常见的并发症以改善患者的结果.
科学领域:
- 危急护理医学
- 传染性疾病
- 公共卫生
背景情况:
- 每年全球有超过1900万人患有败血症,大约有1400万人幸存下来.
- 败血症的生存率有所提高,导致幸存者人数不断增加,他们经常会经历长期的健康后果.
- 目前的败血症指南缺乏医院后护理和患者康复的具体建议.
研究的目的:
- 突出毒症幸存者经历的长期身体,认知和心理健康损害.
- 强调对败血症幸存者的综合性医院后护理策略的需要.
- 鉴定毒性住院后与不良结果相关的常见并发症和危险因素.
主要方法:
- 关于败血症和医院后护理的现有文献和临床指南的审查.
- 对败血症幸存者中损伤和再住院率的数据分析.
- 检查与败血症治疗后不良结果相关的因素.
主要成果:
- 败血症患者经常出现新的功能限制,认知障碍和心理健康问题 (焦虑,抑郁,PTSD).
- 大约40%的败血症幸存者在90天内再次住院,通常是因为感染或慢性疾病的恶化.
- 与其他患者群体相比,败血症幸存者面临复发感染,急性功能衰竭和新的心血管事件的风险增加.
- 专家建议包括推物理治疗以改善功能能力,得到观察数据的支持,显示死亡率降低.
结论:
- 败血症幸存者的医院后治疗必须包括对身体,精神和认知问题的查和治疗.
- 对常见的可治疗疾病如感染和心力衰竭进行定期的药物检查和评估至关重要.
- 对于已经存在不良健康状况的患者,在败血症恢复后,专注于减轻症状可能是适当的.
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