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Sepsis Campaign\uff0cSSC)\u662f\u7f8e\u56fd\u91cd\u75c7\u5b66\u4f1a\u548c\u6b27\u6d32\u91cd\u75c7\u5b66\u4f1a\u7684\u534f\u4f5c\u7ec4\u7ec7\uff0c\u81ea2002\u5e74\u4ee5\u6765\u5df2\u7ecf\u5236\u5b9a\u548c\u66f4\u65b0\u4e864\u7248\u57fa\u4e8e\u4e34\u5e8a\u8bc1\u636e\u7684\u4e34\u5e8a\u6307\u5357<sup>\uff3b4-5\uff3d<\/sup>\uff0c\u6709\u6548\u964d\u4f4e\u4e86\u8113\u6bd2\u75c7\u7684\u53d1\u75c5\u7387\u548c\u6b7b\u4ea1\u7387\u3002\u5bf9\u4e8e\u598a\u5a20\u671f\u548c\u4ea7\u8925\u671f\u8113\u6bd2\u75c7\u7684\u8bca\u6cbb\uff0c\u76ee\u524d\u8fd8\u6ca1\u6709\u7edf\u4e00\u6700\u4f73\u65b9\u6848\uff0cSSC\u6307\u5357\u4e5f\u6ca1\u6709\u4e13\u95e8\u9488\u5bf9\u5b55\u4ea7\u5987\u7684\u5efa\u8bae\uff0c\u5927\u591a\u6570\u4e13\u5bb6\u5efa\u8bae\u9075\u5faaSSC\u8113\u6bd2\u75c7\u6307\u5357\u7684\u76f8\u540c\u539f\u5219\u3002\u6fb3\u5927\u5229\u4e9a\u548c\u65b0\u897f\u5170\u4ea7\u79d1\u533b\u5b66\u4f1a\uff08Society of Obstetric Medicine of Australia and New Zealand\uff0cSOMANZ\uff09\u53ca\u7f8e\u56fd\u6bcd\u80ce\u533b\u5b66\u4f1a(Society for Maternal-Fetal Medicine\uff0cSMFM)\u57282017\u5e74\u548c2019\u5e74\u5148\u540e\u53d1\u5e03\u4e86\u201c\u598a\u5a20\u548c\u4ea7\u8925\u671f\u8113\u6bd2\u75c7\u7ba1\u7406\u6307\u5357\u201d\uff0c\u6307\u51fa\u7531\u4e8e\u56f4\u4ea7\u671f\u6bcd\u4f53\u8840\u6d41\u52a8\u529b\u5b66\u7684\u6539\u53d8\uff0c SSC\u7684\u8113\u6bd2\u75c7\u8bca\u6cbb\u65b9\u6848\u9700\u8981\u505a\u51fa\u76f8\u5e94\u8c03\u6574\uff0c\u4f46\u4ecd\u9700\u8fdb\u4e00\u6b65\u7684\u9a8c\u8bc1<sup>\uff3b6-7\uff3d<\/sup>\u3002<\/p>\n<p>\u4e00\u3001\u598a\u5a20\u671f\u548c\u4ea7\u8925\u671f\u8113\u6bd2\u75c7\u7684\u5b9a\u4e49<\/p>\n<p>\u8113\u6bd2\u75c7\u5b9a\u4e49\u4e3a\u201c\u4eba\u4f53\u5bf9\u611f\u67d3\u7684\u53cd\u5e94\u5931\u8c03\u5f15\u8d77\u7684\u5177\u6709\u751f\u547d\u5371\u9669\u7684\u591a\u5668\u5b98\u529f\u80fd\u969c\u788d\u201d\u3002\u4e16\u754c\u536b\u751f\u7ec4\u7ec7\uff08World Health Organization\uff0cWHO\uff09\u5c06\u598a\u5a20\u548c\u4ea7\u8925\u671f\u8113\u6bd2\u75c7\u5b9a\u4e49\u4e3a\u201c\u5728\u6000\u5b55\u3001\u5206\u5a29\u3001\u6d41\u4ea7\u6216\u4ea7\u540e\u53d1\u751f\u7684\uff0c\u7531\u611f\u67d3\u5f15\u8d77\u7684\u5a01\u80c1\u751f\u547d\u7684\u5668\u5b98\u529f\u80fd\u969c\u788d\u201d<sup>\uff3b8\uff3d<\/sup>\u3002\u8113\u6bd2\u75c7\u662f\u4e00\u79cd\u4e34\u5e8a\u7efc\u5408\u5f81\uff0c\u611f\u67d3\u662f\u6e90\u5934\uff0c\u7531\u4e8e\u5bbf\u4e3b\u5bf9\u611f\u67d3\u7684\u53cd\u5e94\u5931\u8c03\u5bfc\u81f4\u751f\u7406\u3001\u751f\u7269\u5b66\u548c\u751f\u5316\u5f02\u5e38\uff0c\u4e25\u91cd\u8005\u51fa\u73b0\u8840\u6d41\u52a8\u529b\u5b66\u6539\u53d8\u4ee5\u53ca\u7ec6\u80de\u548c\u4ee3\u8c22\u7d0a\u4e71\uff0c\u53d1\u751f\u591a\u5668\u5b98\u529f\u80fd\u969c\u788d\u751a\u81f3\u6b7b\u4ea1\uff0c\u8fd9\u662f\u4e00\u4e2a\u590d\u6742\u7684\u75c5\u7406\u751f\u7406\u8fc7\u7a0b\u3002\u66f4\u65b0\u7684\u8113\u6bd2\u75c7\u5b9a\u4e49\uff0c\u4e0d\u518d\u5305\u542b\u654f\u611f\u6027\u9ad8\u800c\u7279\u5f02\u6027\u4e0d\u8db3\u7684\u5168\u8eab\u708e\u75c7\u53cd\u5e94\u7efc\u5408\u5f81(systemic inflammatory response syndrome\uff0cSIRS)\uff0c\u5f3a\u8c03\u7684\u662f\u591a\u5668\u5b98\u529f\u80fd\u969c\u788d\u3002\u5e8f\u8d2f\u5668\u5b98\u529f\u80fd\u8870\u7aed\u8bc4\u5206(sequential organ failure assessment,SOFA)\u662f\u5224\u65ad\u5668\u5b98\u529f\u80fd\u969c\u788d\u7684\u5de5\u5177\u3002<\/p>\n<p>\u598a\u5a20\u548c\u4ea7\u8925\u671f\u8113\u6bd2\u75c7\u662f\u4e00\u4e2a\u590d\u6742\u7684\u3001\u52a8\u6001\u7684\u7efc\u5408\u75c7\u5019\u7fa4\uff0c\u65e9\u671f\u8bc6\u522b\u5e76\u975e\u6613\u4e8b\uff0c\u7279\u522b\u662f\u6ca1\u6709\u53d1\u70ed\u75c7\u72b6\u7684\u60c5\u51b5\u4e0b\u3002<\/p>\n<p>\u5982\u4f55\u5728\u6700\u77ed\u65f6\u95f4\u5185\u5224\u5b9a\u60a3\u8005\u662f\u5426\u5b58\u5728\u611f\u67d3\uff0c\u5668\u5b98\u529f\u80fd\u969c\u788d\u7a76\u7adf\u662f\u611f\u67d3\u8fd8\u662f\u975e\u611f\u67d3\u539f\u56e0\uff1f\u56f4\u4ea7\u671f\u8113\u6bd2\u75c7\u4f11\u514b\u4f34\u6709\u51dd\u8840\u529f\u80fd\u969c\u788d\u8005\u5982\u4f55\u4e0e\u5931\u8840\u6027\u4f11\u514b\u548c\u7f8a\u6c34\u6813\u585e\u9274\u522b\uff1f<\/p>\n<p>\u7531\u4e8e\u4e34\u5e8a\u4e0a\u8bb8\u591a\u60a3\u8005\u5728\u786e\u8bca\u65f6\u5df2\u8fdb\u5165\u8113\u6bd2\u75c7\u7684\u7ec8\u672b\u9636\u6bb5\uff0c\u5931\u53bb\u6700\u4f73\u6cbb\u7597\u65f6\u673a\uff0c\u56e0\u6b64\u65e9\u671f\u8bca\u65ad\u548c\u6b63\u786e\u5904\u7406\u662f\u6551\u6cbb\u6210\u529f\u7684\u5173\u952e\u3002<\/p>\n<p>\u4e8c\u3001\u598a\u5a20\u671f\u548c\u4ea7\u8925\u671f\u8113\u6bd2\u75c7\u7684\u75c5\u56e0<\/p>\n<p>\u4e0e\u7537\u6027\u76f8\u6bd4\uff0c\u5973\u6027\u4e25\u91cd\u5168\u8eab\u6027\u611f\u67d3\u7684\u53d1\u75c5\u7387\u8f83\u4f4e\uff0c\u4f46\u75c5\u6b7b\u7387\u8f83\u9ad8\u3002\u5bfc\u81f4\u4e0a\u8ff0\u6027\u522b\u5dee\u5f02\u7684\u539f\u56e0\u5c1a\u672a\u9610\u660e\uff0c\u53ef\u80fd\u4e0e\u6027\u6fc0\u7d20\u5f71\u54cd\u56fa\u6709\u514d\u75ab\u53ca\u9002\u5e94\u6027\u514d\u75ab\uff0c\u5e76\u5f71\u54cd\u5fc3\u8840\u7ba1\u7cfb\u7edf\u5bf9\u7ec6\u80de\u56e0\u5b50\u4fe1\u53f7\u7684\u53cd\u5e94\u6709\u5173<sup>\uff3b9\uff3d<\/sup>\u3002\u598a\u5a20\u671f\u548c\u4ea7\u8925\u671f\u8113\u6bd2\u75c7\u7684\u75c5\u56e0\u5728\u4ea7\u524d\u548c\u4ea7\u540e\u5b58\u5728\u5dee\u5f02\u3002<\/p>\n<ul>\n<li>\n<p>\u4ea7\u524d\u8113\u6bd2\u75c7\u6700\u5e38\u89c1\u7684\u539f\u56e0\u662f\u4e25\u91cd\u7684\u611f\u67d3\u6027\u6d41\u4ea7\u3001\u7f8a\u819c\u8154\u611f\u67d3\u3001\u80be\u76c2\u80be\u708e\u548c\u7531\u80ba\u708e\u94fe\u7403\u83cc\u6216\u6d41\u611f\u75c5\u6bd2\u5f15\u8d77\u7684\u80ba\u708e\uff1b<\/p>\n<\/li>\n<li>\n<p>\u4ea7\u540e\u8113\u6bd2\u75c7\u6700\u5e38\u89c1\u7684\u539f\u56e0\u662f\u5b50\u5bab\u5185\u819c\u708e\uff0c\u901a\u5e38\u662f\u538c\u6c27\u83cc\u611f\u67d3\u3001\u9769\u5170\u9634\u6027\u83cc\u548c\u9769\u5170\u9633\u6027\u83cc\u7684\u6df7\u5408\u611f\u67d3\uff0c\u4ee5\u53ca\u5207\u53e3\u611f\u67d3\u3001\u574f\u6b7b\u6027\u7b4b\u819c\u708e\u3001\u76c6\u8154\u8113\u80bf\u3001\u5b50\u5bab\u808c\u5c42\u574f\u75bd\uff08\u901a\u5e38\u5f52\u56e0\u4e8e\u5728\u80c3\u80a0\u9053\u548c\u9634\u9053\u4e2d\u5b9a\u6b96\u7684\u68ad\u83cc\uff09\u3001\u5316\u8113\u6027\u76c6\u8154\u8840\u6813\u6027\u9759\u8109\u708e\u3001\u5316\u8113\u6027\u808c\u708e\u548c\u8270\u96be\u68ad\u83cc\u7ed3\u80a0\u708e\u3002<\/p>\n<\/li>\n<\/ul>\n<p>\u8113\u6bd2\u75c7\u75c5\u539f\u4f53\u4ecd\u4ee5\u9769\u5170\u9634\u6027\u83cc\u4e3a\u4e3b\uff0c\u9769\u5170\u9633\u6027\u83cc\u5448\u589e\u591a\u8d8b\u52bf\u3002\u5e38\u89c1\u7684\u81f4\u75c5\u83cc\u4e3a\u5927\u80a0\u57c3\u5e0c\u83cc\u3001A\u7ec4\u94fe\u7403\u83cc\u3001B\u7ec4\u94fe\u7403\u83cc\u3001\u80ba\u708e\u514b\u96f7\u767d\u6746\u83cc\u3001\u91d1\u9ec4\u8272\u8461\u8404\u7403\u83cc\u3001\u5947\u5f02\u53d8\u5f62\u6746\u83cc\u3001\u80ba\u708e\u94fe\u7403\u83cc\u4ee5\u53ca\u538c\u6c27\u83cc\u3002\u5728\u8fc7\u53bb\u768410\u5e74\u4e2d\uff0c\u771f\u83cc\u68c0\u51fa\u7387\u6709\u6240\u589e\u52a0\uff0c\u4f46\u4ecd\u4f4e\u4e8e\u7ec6\u83cc\u3002<\/p>\n<p>\u4e09\u3001\u598a\u5a20\u671f\u548c\u4ea7\u8925\u671f\u8113\u6bd2\u75c7\u7684\u521d\u7b5b\u548c\u8bc4\u4f30\u65b9\u6cd5<\/p>\n<p>\uff08\u4e00\uff09 \u8113\u6bd2\u75c7\u7684\u521d\u7b5b\u548c\u8bc4\u4f30\u65b9\u6cd5<\/p>\n<p>SOFA\u591a\u5728\u91cd\u75c7\u76d1\u62a4\u75c5\u623f\uff08intensive care unit\uff0cICU\uff09\u5185\u4f7f\u7528\uff0c\u8113\u6bd2\u75c7\u7684\u521d\u7b5b\u548c\u8bc4\u4f30\u6700\u5e38\u7528\u7684\u5de5\u5177\u662f\u5feb\u901f\u5e8f\u8d2f\u5668\u5b98\u529f\u80fd\u8870\u7aed\u8bc4\u5206\uff08quickly sequential organ failure assessment score\uff0cqSOFA\uff09\u4ee5\u53ca\u56fd\u5bb6\u65e9\u671f\u9884\u8b66\u8bc4\u5206\uff08national early warning score, NEWS\uff09\u3002<\/p>\n<p>1.\u5feb\u901f\u5e8f\u8d2f\u5668\u5b98\u529f\u80fd\u8870\u7aed\u8bc4\u5206<\/p>\n<p>qSOFA\u662fSOFA\u7684\u4fee\u6539\u7248\u672c\uff0c\u4ec5\u9700\u8bc4\u4f303\u9879\u4e34\u5e8a\u6307\u6807\uff0c\u65e0\u9700\u7b49\u5f85\u5b9e\u9a8c\u5ba4\u68c0\u67e5\u7ed3\u679c\uff1a\uff081\uff09\u6536\u7f29\u538b\uff1c100 mmHg\uff1b\uff082\uff09\u547c\u5438\u9891\u7387\u226522\u6b21\/min\uff1b\uff083\uff09\u7cbe\u795e\u72b6\u6001\u7684\u6539\u53d8\u3002<\/p>\n<p>\u5bf9\u4e8e\u6bcf\u4e2a\u53d8\u91cf\uff0c\u6ee1\u8db3\u6761\u4ef6\u5f971\u5206\uff0c\u4e0d\u6ee1\u8db30\u5206\uff1b\u5f97\u5206\u22652\uff0c\u60a3\u8005\u4e0d\u826f\u9884\u540e\u98ce\u9669\u589e\u52a0\u3002\u9700\u8981\u6ce8\u610f\u7684\u662f\uff0cqSOFA\u662f\u4e00\u79cd\u7b5b\u67e5\u53d1\u751f\u4e25\u91cd\u5e76\u53d1\u75c7\u9ad8\u5371\u60a3\u8005\u7684\u5feb\u901f\u65b9\u6cd5\uff0c\u5e76\u4e0d\u80fd\u7528\u4e8e\u8113\u6bd2\u75c7\u7684\u8bca\u65ad\u3002<\/p>\n<p>qSOFA\u5bf9\u8113\u6bd2\u75c7\u75c5\u6b7b\u7387\u7684\u9884\u6d4b\u6548\u679c\u4e0d\u53caSOFA\uff0c\u66f4\u591a\u7528\u4e8e\u91cd\u75c7\u76d1\u62a4\u75c5\u623f\u4ee5\u5916\uff0c\u5bf9\u8113\u6bd2\u75c7\u8bc6\u522b\u3001\u76d1\u6d4b\u53ca\u6cbb\u7597\u51b3\u7b56\u5177\u6709\u79ef\u6781\u610f\u4e49\u3002<\/p>\n<p>2.\u56fd\u5bb6\u65e9\u671f\u9884\u8b66\u8bc4\u5206<\/p>\n<p>NEWS\u662f\u5feb\u901f\u8bc4\u4ef7\u75c5\u60c5\u4e25\u91cd\u7a0b\u5ea6\u7684\u5de5\u5177\uff0c\u66f4\u591a\u5e94\u7528\u4e8e\u6025\u8bca\u533b\u5b66\u9886\u57df\u3002NEWS\u6bd4qSOFA\u66f4\u80fd\u5168\u9762\u5730\u8bc4\u4f30\u60a3\u8005\u7684\u5371\u91cd\u60c5\u51b5\u3002<\/p>\n<p>NEWS\u662f\u4ece6\u4e2a\u751f\u7406\u53c2\u6570\u5f97\u51fa\u7684\u7efc\u5408\u8bc4\u5206\u7cfb\u7edf\uff1a\u547c\u5438\u9891\u7387\u3001\u6c27\u9971\u548c\u5ea6\u3001\u6536\u7f29\u538b\u3001\u5fc3\u7387\u3001\u610f\u8bc6\u6c34\u5e73\u53ca\u4f53\u6e29\uff0c\u6bcf\u9879\u8bc4\u52060\uff5e3\u5206\u3002\u603b\u4f53\u8bc4\u5206\u4ee3\u8868\u8113\u6bd2\u75c7\u5bfc\u81f4\u7684\u6b7b\u4ea1\u98ce\u9669\u5e76\u8868\u660e\u53cd\u5e94\u7684\u7d27\u8feb\u6027\uff0c0\uff5e4\u5206\u4e3a\u4f4e\u98ce\u9669\uff0c5\uff5e6\u5206\u4e3a\u4e2d\u7b49\u98ce\u9669\uff0c7\u5206\u4ee5\u4e0a\u4e3a\u9ad8\u98ce\u9669\u3002<\/p>\n<p>\u5bf9\u4e8eqSOFA\u22652\u5206\uff0c\u6216NEWS\u8bc4\u5206\u4e3a\uff14\uff5e\uff16\u5206\u7684\u60a3\u8005\u9700\u8981\u91cd\u70b9\u5173\u6ce8\uff0c\u53ca\u65f6\u91c7\u53d6\u5e72\u9884\u63aa\u65bd\uff0c\u6bcf\uff12\u5c0f\u65f6\u8fdb\u884c\u91cd\u590d\u8bc4\u5206\uff0c\u52a8\u6001\u7ba1\u7406\u3002NEWS\u8bc4\u5206\u7cfb\u7edf\u89c1\u88681<sup>\uff3b10\uff3d<\/sup>\u3002&nbsp;<\/p>\n<p>\uff08\u4e8c\uff09\u598a\u5a20\u548c\u4ea7\u8925\u671f\u8113\u6bd2\u75c7\u7684\u521d\u7b5b\u548c\u8bc4\u4f30\u65b9\u6cd5<\/p>\n<p>1.\u4ea7\u79d1\u6539\u826f\u7684qSOFA<\/p>\n<p>\u598a\u5a20\u7684\u751f\u7406\u53d8\u5316\u4f7f\u5f97\u8113\u6bd2\u75c7\u7684\u521d\u7b5b\u548c\u8bc4\u4f30\u66f4\u52a0\u590d\u6742\u5316\uff0c\u5f53\u4f7f\u7528\u975e\u598a\u5a20\u6807\u51c6\u65f6\uff0c\u598a\u5a20\u548c\u4ea7\u8925\u671f\u8113\u6bd2\u75c7\u53ef\u80fd\u51fa\u73b0\u8bca\u65ad\u4e0d\u8db3\u6216\u8fc7\u5ea6\u8bca\u65ad\u3002<\/p>\n<p>\u56e0\u6b64\uff0cSOMANZ 2017\u5e74\u7248\u6307\u5357\u63d0\u51fa\u4ea7\u79d1\u6539\u826f\u7684qSOFA\uff1a\uff081\uff09\u6536\u7f29\u538b\uff1c90 mmHg\uff1b\uff082\uff09\u547c\u5438\u9891\u7387\u226525\u6b21\/min\uff1b\uff083\uff09\u7cbe\u795e\u72b6\u6001\u7684\u6539\u53d8<sup>\uff3b6\uff3d<\/sup>\u3002<\/p>\n<p>2.\u598a\u5a20\u548c\u4ea7\u8925\u671f\u8113\u6bd2\u75c7\u8bc4\u5206<\/p>\n<p>Albright\u7b49<sup>\uff3b11\uff3d<\/sup>\u5efa\u8bae\u5e94\u7528\u598a\u5a20\u548c\u4ea7\u8925\u671f\u8113\u6bd2\u75c7\u8bc4\u5206\u9884\u6d4b\u8113\u6bd2\u75c7\uff0c\u751f\u7406\u53c2\u6570\u5305\u62ec\u4ea7\u5987\u4f53\u6e29\u3001\u8840\u538b\u3001\u5fc3\u7387\u3001\u547c\u5438\u3001\u5916\u56f4\u8840\u6c27\u9971\u548c\u5ea6\u3001\u767d\u7ec6\u80de\u8ba1\u6570\u548c\u4e73\u9178\u6c34\u5e73\uff0c\u8bc4\u5206\u22656 \u5206\u9884\u6d4b\u8113\u6bd2\u75c7\u7684\u654f\u611f\u5ea6\u4e3a64\uff05\uff0c\u7279\u5f02\u5ea6\u4e3a88\uff05\uff0c\u9633\u6027\u9884\u6d4b\u503c\u4e3a15\uff05\uff0c\u9634\u6027\u9884\u6d4b\u503c\u4e3a98.6\uff05\u3002<\/p>\n<p>\u4ea7\u79d1\u6539\u826fqSOFA\u8bc4\u5206\u53ca\u8113\u6bd2\u75c7\u8bc4\u5206\uff0c\u5728\u5b55\u4ea7\u5987\u4eba\u7fa4\u4e2d\u5e38\u89c4\u4f7f\u7528\uff0c\u5c1a\u9700\u8981\u8fdb\u4e00\u6b65\u9a8c\u8bc1<sup>\uff3b12-13\uff3d<\/sup>\u3002<\/p>\n<p>\u56db\u3001\u598a\u5a20\u671f\u548c\u4ea7\u8925\u671f\u8113\u6bd2\u75c7\u7684\u96c6\u675f\u5316\u6cbb\u7597<\/p>\n<p>\uff08\u4e00\uff09\u8113\u6bd2\u75c7\u7684\u96c6\u675f\u5316\u6cbb\u7597<\/p>\n<p>\u8113\u6bd2\u75c7\u662f\u7d27\u6025\u533b\u7597\u4e8b\u4ef6\uff0c\u9700\u8981\u7d27\u6025\u8bc4\u4f30\u548c\u6cbb\u7597\u3002\u65e2\u5f80\u96c6\u675f\u5316\u6cbb\u7597\u6307\u5357\u8ba4\u4e3a\u6db2\u4f53\u590d\u82cf\u7b56\u7565\u662f\u65e9\u671f\u76ee\u6807\u5bfc\u5411\u7597\u6cd5(early goal directed therapy\uff0cEGDT)\uff0c\u5373\u521d\u59cb\u6db2\u4f53\u590d\u82cf\u5e94\u57286 h\u5185\u8fbe\u5230\u4ee5\u4e0b\u76ee\u6807\uff1a\u4e2d\u5fc3\u9759\u8109\u538b8\uff5e12 mmHg\uff0cMAP\u226565 mmHg\uff1b\u5c3f\u91cf\u22650.5 ml\/\uff08kg\u00b7h\uff09\uff0c\u4e2d\u5fc3\u9759\u8109\u8840\u6c27\u9971\u548c\u5ea6(central venous oxygen saturation\uff0cScvO2)\u226570%\uff0c\u5c3d\u5feb\u964d\u4f4eqSOFA\u53caNEWS\u8bc4\u5206\u3002\u4f46\u968f\u540e\u7684\u591a\u9879\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u548cmeta\u5206\u6790\u90fd\u672a\u80fd\u8bc1\u5b9eEGDT\u964d\u4f4e\u8113\u6bd2\u75c7\u75c5\u6b7b\u7387\u7684\u6548\u679c<sup>\uff3b13\uff3d<\/sup>\u3002&nbsp;\u5728SSC\u8113\u6bd2\u75c7\u6307\u5357\uff082016\u7248\uff09\u57fa\u7840\u4e0a\uff0cSSC\u53d1\u5e03\u4e862018\u7248\u201c1\u5c0f\u65f6\u96c6\u675f\u5316\u6cbb\u7597(hour-1 bundle)\u201d\u6307\u5357<sup>\uff3b4\uff3d<\/sup>\uff0c\u5bf9\u8113\u6bd2\u75c7\u7684\u65e9\u671f\u8bca\u65ad\u548c\u65e9\u671f\u5e72\u9884\u63d0\u51fa\u4e86\u66f4\u9ad8\u7684\u8981\u6c42\uff0c\u5f3a\u8c03\u5bf9\u8113\u6bd2\u75c7\u60a3\u8005\u7acb\u5373\u8fdb\u884c\u6db2\u4f53\u590d\u82cf\u548c\u5bf9\u75c7\u6cbb\u7597\u7684\u91cd\u8981\u6027<sup>\uff3b12\uff3d<\/sup>\u3002\u96c6\u675f\u5316\u6cbb\u7597\u5305\u62ec\u4ee5\u4e0b\u63aa\u65bd\uff1a<\/p>\n<p>\uff081\uff09\u7acb\u5373\u68c0\u6d4b\u8840\u4e73\u9178\u6c34\u5e73\uff0c\u5982\u679c\u8840\u4e73\u9178\uff1e2 mmol\/L\uff0c\u9700\u8981\u52a8\u6001\u76d1\u6d4b\uff1b&nbsp;<\/p>\n<p>\uff082\uff09\u5728\u4f7f\u7528\u6297\u751f\u7d20\u524d\u7559\u53d6\u6837\u672c,\u8fdb\u884c\u8840\u57f9\u517b\uff1b<\/p>\n<p>\uff083\uff09\u4f4e\u8840\u538b\u6216\u4e73\u9178\u22654 mmol\/L\u65f6\u8865\u6db2\uff0c\u5feb\u901f\u8865\u5145\u6676\u4f53\u6db230 ml\/kg\uff1b<\/p>\n<p>\uff084\uff09\u91c7\u7528\u5e7f\u8c31\u6297\u751f\u7d20\u6cbb\u7597\uff1b<\/p>\n<p>\uff085\uff09\u5b58\u5728\u5371\u53ca\u751f\u547d\u7684\u4f4e\u8840\u538b\u65f6\u91c7\u7528\u8840\u7ba1\u5347\u538b\u836f\uff0c\u7ef4\u6301\u5e73\u5747\u52a8\u8109\u538b\uff08mean arterial pressure\uff0cMAP\uff09\u226565 mmHg(1 mmHg=0.133 kPa)\u3002<\/p>\n<p>1 \u5c0f\u65f6\u96c6\u675f\u5316\u6cbb\u7597\u5f3a\u8c03\u5728\u8113\u6bd2\u75c7\u8bca\u65ad\u540e\u76841\u5c0f\u65f6\u5185\u8fc5\u901f\u91c7\u7528\u4ee5\u4e0a\u5168\u90e8\u63aa\u65bd\uff0c\u907f\u514d\u5728\u60a3\u8005\u5df2\u7ecf\u5b58\u5728\u4f4e\u8840\u538b\u65f6\u6db2\u4f53\u590d\u82cf\u548c\u8840\u6d41\u52a8\u529b\u5b66\u7684\u76d1\u6d4b\u7684\u5ef6\u8bef\u3002<\/p>\n<p>\uff08\u4e8c\uff09\u598a\u5a20\u671f\u548c\u4ea7\u8925\u671f\u8113\u6bd2\u75c7\u96c6\u675f\u5316\u6cbb\u7597\u7684\u76f8\u5173\u95ee\u9898<\/p>\n<p>\u5c3d\u7ba1\u5c1a\u65e0\u5173\u4e8e\u598a\u5a20\u671f\u95f4\u65e9\u671f\u76ee\u6807\u5bfc\u5411\u7597\u6cd5\u7684\u524d\u77bb\u6027\u7814\u7a76\uff0c\u4f46\u8113\u6bd2\u75c7\u7684\u6cbb\u7597\u5e94\u4e0e\u975e\u598a\u5a20\u60a3\u8005\u76f8\u4f3c\uff0c\u5e76\u4f7f\u7528\u76f8\u540c\u7684\u9776\u6807\u3002\u9700\u8981\u6ce8\u610f\u7684\u662f\uff0cScvO2\u5728\u598a\u5a20\u665a\u671f\u7684\u540e\u671f\u4f1a\u6709\u751f\u7406\u6027\u964d\u4f4e\u3002\u598a\u5a20\u548c\u4ea7\u8925\u671f\u8113\u6bd2\u75c7\u4ea6\u5f3a\u8c031\u5c0f\u65f6\u96c6\u675f\u5316\u6cbb\u7597\uff0c\u6cbb\u7597\u5ef6\u8bef\u53ef\u589e\u52a0\u60a3\u8005\u6b7b\u4ea1\u98ce\u9669<sup>\uff3b14\uff3d<\/sup>\u3002&nbsp;1.\u6db2\u4f53\u590d\u82cf&nbsp;\u53d1\u70ed\u3001\u9759\u8109\u6269\u5f20\u548c\u6bdb\u7ec6\u8840\u7ba1\u6e17\u6f0f\u5747\u662f\u5bfc\u81f4\u8113\u6bd2\u75c7\u60a3\u8005\u8840\u5bb9\u91cf\u76f8\u5bf9\u4e0d\u8db3\u7684\u5e38\u89c1\u539f\u56e0\uff0c\u5982\u679c\u51fa\u73b0\u4f4e\u8840\u538b\u6216\u4f4e\u704c\u6ce8\uff0c\u6db2\u4f53\u590d\u82cf\u5e94\u4f5c\u4e3a\u521d\u59cb\u5e72\u9884\u7684\u4e00\u90e8\u5206\u3002\u6db2\u4f53\u590d\u82cf\u53ef\u4ee5\u63d0\u9ad8\u5faa\u73af\u5bb9\u91cf\u3001\u7ea0\u6b63\u4f4e\u8840\u538b\u3001\u6539\u5584\u7ec4\u7ec7\u704c\u6ce8\uff0c\u662f\u8113\u6bd2\u75c7\u6cbb\u7597\u7684\u5173\u952e\u3002SSC\u63a8\u8350\u5feb\u901f\u8865\u5145\u6676\u4f53\u6db230 ml\/kg\uff0c\u7531\u4e8e\u5927\u91cf\u8f93\u6db2\u53ef\u589e\u52a0\u80ba\u6c34\u80bf\u98ce\u9669\uff0c\u8fd9\u4e00\u63a8\u8350\u53ef\u80fd\u4e0d\u9002\u7528\u5b55\u4ea7\u671f\u60a3\u8005\u3002\u5bf9\u4e8e\u598a\u5a20\u548c\u4ea7\u8925\u671f\u8113\u6bd2\u75c7\uff0c\u5efa\u8bae\u521d\u59cb\u590d\u82cf\u8865\u6db2\u91cf\u4e3a1000\uff5e2000 ml\uff0c\u8fdb\u4e00\u6b65\u7684\u6db2\u4f53\u6cbb\u7597\u5e94\u4ee5\u52a8\u6001\u76d1\u6d4b\u524d\u8d1f\u8377\u4e3a\u6307\u5bfc\uff0c\u4ee5\u907f\u514d\u53d1\u751f\u5fc3\u6e90\u6027\u6216\u975e\u5fc3\u6e90\u6027\u80ba\u6c34\u80bf\u3002\u5728\u6700\u521d\u7684\u6db2\u4f53\u590d\u82cf\u540e\uff0c\u5e73\u5747\u52a8\u8109\u538b\u548c\u5176\u4ed6\u6307\u6807\u6ca1\u6709\u6539\u5584\uff0c\u5c31\u9700\u8981\u7ed9\u4e88\u8840\u7ba1\u52a0\u538b\u836f\u7269\u3002<\/p>\n<p>\u63a8\u8350\u590d\u82cf\u7684\u9996\u9009\u6db2\u4f53\u662f\u7b49\u6e17\u6676\u4f53\u6db2\uff0c\u901a\u5e38\u4e3a\u751f\u7406\u76d0\u6c34\u3001\u6797\u683c\u6db2\u7b49\uff1b\u767d\u86cb\u767d\u53ef\u7528\u4e8e\u6db2\u4f53\u590d\u82cf\u7684\u8865\u5145\u6cbb\u7597\uff0c\u4e0e\u6676\u4f53\u6db2\u76f8\u6bd4\uff0c\u767d\u86cb\u767d\u5e76\u65e0\u660e\u786e\u76ca\u5904\uff1b\u4e0d\u63a8\u8350\u5e94\u7528\u7f9f\u4e59\u57fa\u6dc0\u7c89\uff1b\u9ad8\u6c2f\u6db2\u4f53\u53ef\u5bfc\u81f4\u6025\u6027\u80be\u810f\u635f\u4f24\uff1b\u8840\u6db2\u5236\u54c1\u7528\u4e8e\u6025\u6027\u5931\u8840\u6216\u4e25\u91cd\u8d2b\u8840\u7684\u60c5\u51b5\u3002<\/p>\n<p>&nbsp;2.\u8840\u7ba1\u52a0\u538b\u836f&nbsp;\u8840\u7ba1\u52a0\u538b\u836f\u548c\u6b63\u6027\u808c\u529b\u836f\u53ef\u6536\u7f29\u5b50\u5bab\u8840\u7ba1\uff0c\u51cf\u5c11\u80ce\u513f\u7684\u8840\u6d41\u91cf\u3002\u56e0\u6b64\uff0c\u5e94\u9996\u5148\u4f7f\u7528\u5176\u4ed6\u5e72\u9884\u63aa\u65bd\u6765\u63a7\u5236\u4f4e\u8840\u538b\uff0c\u4f8b\u5982\u9759\u8109\u8f93\u6db2\u5e76\u5c06\u60a3\u8005\u7f6e\u4e8e\u5de6\u4fa7\u5367\u4f4d\uff0c\u4ee5\u9632\u6b62\u598a\u5a20\u5b50\u5bab\u538b\u8feb\u4e0b\u8154\u9759\u8109\u3002\u4f46\u5982\u679c\u5b9e\u65bd\u4e86\u8fd9\u4e9b\u6700\u521d\u7684\u5e72\u9884\uff0c\u60a3\u8005\u4ecd\u6301\u7eed\u5b58\u5728\u4f4e\u8840\u538b\uff0c\u5219\u9700\u8981\u8840\u7ba1\u52a0\u538b\u836f\u7269\u6cbb\u7597\u3002\u4f7f\u7528\u8840\u7ba1\u52a0\u538b\u836f\uff0c\u4e3b\u8981\u76ee\u7684\u662f\u6291\u5236\u4f53\u5faa\u73af\u7684\u75c5\u7406\u6027\u6269\u5f20\uff0c\u7ef4\u6301\u7ec4\u7ec7\u704c\u6ce8\u3002\u54ea\u79cd\u836f\u7269\u6700\u9002\u5408\u56e0\u91cd\u75c7\u5f15\u8d77\u7684\u4ea7\u5987\u4f4e\u8840\u538b\u6216\u4f11\u514b\uff0c\u76ee\u524d\u5c1a\u7f3a\u4e4f\u8db3\u591f\u7684\u4e34\u5e8a\u7814\u7a76\u3002\u5f53\u598a\u5a20\u548c\u4ea7\u8925\u671f\u8113\u6bd2\u75c7\u60a3\u8005\u5b9e\u65bd\u6db2\u4f53\u590d\u82cf\u540e\u4ecd\u51fa\u73b0\u6301\u7eed\u6027\u4f4e\u8840\u538b\u548c\uff08\u6216\uff09\u4f4e\u704c\u6ce8\u60c5\u51b5\u65f6\uff0c\u53bb\u7532\u80be\u4e0a\u817a\u7d20\u63a8\u8350\u505a\u4e3a\u4e00\u7ebf\u8840\u7ba1\u52a0\u538b\u836f\u3002\u5c3d\u7ba1\u53bb\u7532\u80be\u4e0a\u817a\u7d20\u53ef\u4ee5\u51cf\u5c11\u5b50\u5bab\u8840\u6d41\u91cf\uff0c\u4f46\u6ca1\u6709\u6570\u636e\u8868\u660e\u53bb\u7532\u80be\u4e0a\u817a\u7d20\u5bf9\u80ce\u513f\u7684\u5065\u5eb7\u6709\u4e0d\u5229\u5f71\u54cd\u3002\u5bf9\u975e\u598a\u5a20\u60a3\u8005\u7684\u5efa\u8bae\u662f\u7ef4\u6301\u5e73\u5747\u52a8\u8109\u538b\uff1e65 mmHg\uff0c\u5bf9\u4e8e\u598a\u5a20\u671f\u60a3\u8005\u5982\u679c\u6ca1\u6709\u5982\u7cbe\u795e\u72b6\u6001\u6539\u53d8\u3001\u5c11\u5c3f\u3001\u8840\u6e05\u4e73\u9178\u5347\u9ad8\u3001\u56db\u80a2\u53a5\u51b7\u7b49\u704c\u6ce8\u4e0d\u8db3\u7684\u4e34\u5e8a\u8868\u73b0\uff0c\u53ef\u4ee5\u7a0d\u4f4e\u4e8e\u6b64\u8840\u538b\u6c34\u5e73\uff0c\u4e2a\u4f53\u5316\u7ba1\u7406\u3002\u5bf9\u4e8e\u96be\u6cbb\u6027\u4f11\u514b\u7684\u5b55\u5987\uff0c\u53bb\u6c27\u80be\u4e0a\u817a\u7d20\u53ef\u80fd\u662f\u5408\u7406\u7684\u4e8c\u7ebf\u836f\u7269\u3002\u9ebb\u9ec4\u78b1\u4e0e\u80ce\u513f\u9178\u4e2d\u6bd2\u6709\u5173\uff0c\u800c\u82ef\u80be\u4e0a\u817a\u7d20\u4e0e\u6bcd\u4eb2\u5fc3\u52a8\u8fc7\u7f13\u6709\u5173\u3002\u591a\u5df4\u915a\u4e01\u80fa\u662f\u4e00\u79cd\u6b63\u6027\u808c\u529b\u836f\uff08\u589e\u52a0\u5fc3\u8f93\u51fa\u91cf\uff09\uff0c\u800c\u4e0d\u662f\u8840\u7ba1\u52a0\u538b\u836f\uff0c\u5728\u5fc3\u808c\u529f\u80fd\u969c\u788d\u6216\u6301\u7eed\u704c\u6ce8\u4e0d\u8db3\u7684\u60c5\u51b5\u4e0b\uff0c\u63a8\u8350\u5e94\u7528\u591a\u5df4\u915a\u4e01\u80fa\u3002\u5bf9\u4e8e\u79ef\u6781\u7684\u6db2\u4f53\u590d\u82cf\u548c\u5347\u538b\u836f\u6cbb\u7597\u5747\u53cd\u5e94\u4e0d\u826f\u7684\u96be\u6cbb\u6027\u8113\u6bd2\u75c7\u4f11\u514b\u60a3\u8005\uff0c\u53ef\u4ee5\u8003\u8651\u4f7f\u7528\u6c22\u5316\u53ef\u7684\u677e\u3002\u4e0d\u63a8\u8350\u5728\u598a\u5a20\u548c\u4ea7\u8925\u671f\u8113\u6bd2\u75c7\u5e38\u89c4\u4f7f\u7528\u76ae\u8d28\u7c7b\u56fa\u9187\u3002&nbsp;3.\u6297\u751f\u7d20\u6cbb\u7597&nbsp;\u5f53\u7591\u4f3c\u6216\u786e\u8bca\u598a\u5a20\u548c\u4ea7\u8925\u671f\u8113\u6bd2\u75c7\u65f6\uff0c\u57281 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ME, Bateman BT, Bauer ST, et al. 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Intensive Care Med, 2017, 43(3):304-377\uff0e\uff3b6\uff3d&nbsp;Bowyer L, Robinson HL, Barrett H, et al. SOMANZ guidelines for the investigation and management sepsis in pregnancy\uff3bJ\uff3d. Aust N Z J Obstet Gynaecol, 2017, 57(5):540-551.\uff3b7\uff3d&nbsp;Plante LA, Pacheco LD, Louis JM. SMFM consult series # 47: Sepsis during pregnancy and the puerperium\uff3bJ\uff3d. Am J Obstet Gynecol, 2019, 220(4):B2-B10\uff0e\uff3b8\uff3d&nbsp;World Health Organisation. Statement on MaternalSepsis\uff3bEB\/OL\uff3d. (2017)\uff3b2020-10-9\uff3d.https:\/\/www.\/reproductivehealth\/publications\/maternal_perinatal_health\/maternalsepsis-statement\/en\/\uff3b9\uff3d&nbsp;RE Bridwell, BM Carius, B Long. 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Obstet Gynecol,2017, 130(4):747-755.\uff3b12\uff3d&nbsp;\u4e2d\u56fd\u533b\u5e08\u534f\u4f1a\u6025\u8bca\u533b\u5e08\u5206\u4f1a.\u4e2d\u56fd\u8113\u6bd2\u75c7\/\u8113\u6bd2\u6027\u4f11\u514b\u6025\u8bca\u6cbb\u7597\u6307\u5357\uff082018\uff09\uff3bJ\uff3d.\u4e34\u5e8a\u6025\u8bca\u6742\u5fd7, 2018,19(9):567-588.\uff3b13\uff3d&nbsp;\u5f6d\u5fd7\u52c7.\u62ef\u6551\u8113\u6bd2\u75c7\u8fd0\u52a8\u8113\u6bd2\u75c7\u6307\u53572018\u66f4\u65b0\u7684\u542f\u793a\uff3bJ\uff3d.\u533b\u5b66\u7814\u7a76\u751f\u5b66\u62a5,2019,32(1):18-20.\uff3b14\uff3d&nbsp;Barton JR, Sibai BM. Severe sepsis and septic shock in pregnancy\uff3bJ\uff3d. Obstet Gynecol, 2012, 120(3):689-706.&nbsp;\uff3b15\uff3d&nbsp;Kendle AM, Salemi JL, Tanner JP,et al. Delivery-associated sepsis: trends in prevalence and mortality\uff3bJ\uff3d. Am J Obstet Gynecol, 2019, 220(4): 391.e1-391.e16.&nbsp;<\/p>\n<p>\u8fde\u5ca9, \u738b\u8c22\u6850. \u598a\u5a20\u671f\u548c\u4ea7\u8925\u671f\u8113\u6bd2\u75c7\u8bca\u65ad\u4e0e\u6cbb\u7597 \uff3bJ\/CD\uff3d. \u4e2d\u534e\u4ea7\u79d1\u6025\u6551\u7535\u5b50\u6742\u5fd7\uff0c 2020\uff0c 9(4): 208-212.\u6765\u6e90\uff1a\u4ea7\u79d1\u6025\u6551\u5728\u7ebf<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u3010\u6458\u8981\u3011 \u598a\u5a20\u671f\u548c\u4ea7\u8925\u671f\u8113\u6bd2\u75c7\u662f\u5bfc\u81f4\u5b55\u4ea7\u5987\u6b7b\u4ea1\u7684\u91cd\u8981\u539f\u56e0\u4e4b\u4e00\uff0c\u8d77\u75c5\u6025\u3001\u8fdb\u5c55\u5feb\uff0c\u5ef6 &hellip; <a href=\"http:\/\/zydq.1006ss.com\/?p=31317\">\u7ee7\u7eed\u9605\u8bfb <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[70],"tags":[],"class_list":["post-31317","post","type-post","status-publish","format-standard","hentry","category-70"],"_links":{"self":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/posts\/31317","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=31317"}],"version-history":[{"count":0,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/posts\/31317\/revisions"}],"wp:attachment":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=31317"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=31317"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=31317"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}