外科手术期间的氧化应激和败血症:病理生理学和临床影响
Alice Nicoleta Dragoescu1, Vlad Padureanu2, Andreea Doriana Stanculescu1
1Department of Anesthesiology and Intensive Care, University of Medicine and Pharmacy of Craiova, Craiova, ROU.
Cureus
|October 20, 2025
概括
涉及反应性氧物种 (ROS) 和反应性物种 (RNS) 的外科手术期间的氧化应激会显著影响败血症的恢复. 早期感染控制和流体管理是关键,但针对性的抗氧化疗法需要进一步研究.
科学领域:
- 临界护理医学 临界护理医学
- 生物化学 生物化学
- 手术科学 手术科学
背景情况:
- 术后氧化应激,其特点是过度的反应性氧物种 (ROS) 和反应性物种 (RNS) 生产,是手术和重症病恢复的关键因素.
- 这种由外科创伤,麻醉,低 perfusion 和感染引起的压力导致线粒体损伤,内皮功能障碍和免疫失调,促进炎症和器官系统衰竭.
研究的目的:
- 审查当前关于外科手术期间氧化应激和败血症机制的知识.
- 讨论治疗的含义和新的治疗策略,以管理氧化应激在术后败血症.
主要方法:
- 在PubMed,Web of Science和Scopus进行了全面的文献搜索.
- 在2000年至2025年间发表的英语同行评审研究被纳入,使用关键词:"氧化应激"",外科"和"败血症".
主要成果:
- 减轻氧化损伤的有效策略包括早期感染控制,维持正常氧化和精确的液体管理.
- 尽管了解氧化应激机制,但向性抗氧化剂治疗尚未成功转化为临床实践.
结论:
- 进一步的研究应该集中在通过生物标志物测试和通过临床试验评估线粒体保护作用的指导下开发个性化的抗氧化剂治疗.
- 将机理性见解与临床实践相结合,对于调节氧化应激至关重要,以提高败血症和高风险手术患者的存活率.
相关概念视频
Chronic Obstructive Pulmonary Disease-II: Pathophysiology
4.2K
Chronic Obstructive Pulmonary Disease (COPD) pathophysiology is intricate and multifaceted, involving a complex interplay of physiological processes. Understanding these mechanisms is crucial for effectively managing and treating COPD. Here is an in-depth look at the critical elements in the pathophysiology of COPD:
Chronic Inflammation
Chronic Inflammation
4.2K
Cardiomyopathy VII: Pre and Post Operative Nursing Management
283
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
283
Oxygen Requirements and Growth Patterns
1.2K
Microorganisms exhibit diverse oxygen requirements and growth patterns driven by their metabolic strategies and environmental adaptations. Oxygen, while essential for many organisms, can also be toxic under certain conditions, shaping how microorganisms grow and survive.Oxygen Requirements of MicroorganismsMicroorganisms are classified based on their ability to use or tolerate oxygen:● Obligate aerobes like Mycobacterium tuberculosis need oxygen for energy production, as it serves as the...
1.2K
Peripheral Artery Disease V: Postoperative Nursing Management
372
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
372
Acute Kidney Injury II: Pathophysiology
876
Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
876
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
351
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
351


