国际麻醉学与复苏杂志   2018, Issue (11): 0-0
    
脓毒症相关性脑病的研究进展
杨光, 鲁卫华, 金孝岠1()
1.安徽省芜湖市皖南医学院弋矶山医院重症医学科
Research progress of sepsis-associated encephalopathy
 全文:
摘要:

背景 脓毒症相关性脑病(sepsis-associated encephalopathy, SAE)是脓毒症常见的一种并发症,主要表现为精神状态的急剧恶化。SAE发病机制复杂,诊断标准尚未确定,尚无特效的治疗方法和药物,严重影响脓毒症患者的预后。 目的 综述SAE的主要发病机制、 临床表现、诊断和治疗,寻找潜在的深入研究的突破点。 内容 阐述SAE的研究概况、发病机制、临床表现、诊断和治疗的最新进展。 趋向 SAE的确切机制和有效防治措施仍需要进一步研究阐明。

关键词: 脓毒症相关性脑病; 发病机制; 诊断; 治疗
Abstract:

Background Sepsis-associated encephalopathy (SAE) is a common complication of sepsis, and rapid deterioration in mental status is one of the major manifestations of SAE. The complicated pathogenesis of SAE poses uncertainty to its diagnosis. As the treatment of SAE is also understudied, the prognosis of patients with SAE is unpredictable. Objective This article reviews the status quo of studies in SAE, including its pathogenesis, clinical manifestations, diagnosis, and treatment. Content The pathology of SAE includes damage of blood-brain-barrier, alterations of neurotransmitter release and hemodynamics in the brain, mitochondrial dysfunction and apoptosis of neurons, neuroinflammation, etc. The diagnosis of SAE currently relies on deterioration of consciousness, abnormal spectra in electroencephalograph, disruption of somatosensory evoked potentials, morphological changes, and biochemical parameters representing brain injury. The available treatment strategies include antisepsis, anti-inflammation, mechanical ventilation, and neuroprotection. Trend The pathogenesis of SAE remains unclear. There still lacks effective intervention to improve the prognosis of SAE. Further investigations are highly demanded to elucidate the pathogenesis of SAE, and to improve the therapeutic strategies.

Key words: Sepsis associated encephalopathy; Pathogenesis; Diagnosis; Treatment