创伤弧菌脓毒症诊疗方案（2018）

doi:10.3969/j.issn.1002-1949.2018.07.003

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摘要创伤弧菌脓毒症是由创伤弧菌（Vibrio vulnificus）感染导致的急重症，起病急、进展凶猛，救治困难，50%~70%的患者在48 h内死于感染性休克及多脏器衰竭。该疾病散发，相对少见，多数临床医师对该病的诊治缺乏相应的经验，由此造成延误诊治的案例时有发生。2008年，我们根据自己多年的实践经验，结合国内外文献，编写并发表了《创伤弧菌脓毒症诊治方案（草案）》用以指导创伤弧菌脓毒症的诊治。该方案提出创伤弧菌脓毒症早期临床诊断标准、早期足量联合应用抗菌药物、尽早外科处理感染灶等核心治疗理念，明显降低了患者病死率，使患者病死率由原先的75%下降至26.3%。 十年来，创伤弧菌微生物检测技术取得长足进步，影像学在坏死性筋膜炎诊断中也积累不少了经验，更为重要的是新版的严重脓毒症及感染性休克诊治指南的颁布、坏死性筋膜炎治疗指南的修订为创伤弧菌脓毒症的诊疗提供了新的指导意见。同时，我们在创伤弧菌脓毒症外科手术治疗、流程建设与管理实践中也取得新进展。因此，为进一步规范创伤弧菌脓毒症的诊疗，提高患者救治成功率，我们再次组织专家对《创伤弧菌脓毒症诊疗方案（草案）》进行修订。修订后的方案不仅体现了最新进展，而且提出了多学科协作的临床救治流程，并分环节加以阐述，使其对临床实践具有更好的指导性和操作性。

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	洪广亮
	卢才教
	赵光举
	郭海雷
	陈隆望
	李萌芳
	吴斌
	卢中秋

基金资助:国家自然科学基金项目（81571937，81772112）；浙江省“十二五”重点学科建设计划资助项目；浙江省医学创新学科计划（11-CX26）；浙江省中医药重点学科计划（2012-XK-A28）

通讯作者: 卢中秋（1965-），男，教授，主任医师，博士生导师，E-mail:lzq640815@163.com。

引用本文:

洪广亮，卢才教，赵光举，郭海雷，陈隆望，李萌芳，吴斌，卢中秋. 创伤弧菌脓毒症诊疗方案（2018）[J]. 中国急救医学, 2018, 38(7): 575-580.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2018.07.003 或 http://www.cnemergency.org.cn/CN/Y2018/V38/I7/575

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