微循环障碍研究进展对烧伤休克和烧伤脓毒症休克治疗的启发

郇京宁; 张利军

doi:10.3760/cma.j.cn501225-20220323-00082

微循环障碍研究进展对烧伤休克和烧伤脓毒症休克治疗的启发

doi: 10.3760/cma.j.cn501225-20220323-00082

郇京宁^,,
张利军

深圳大学第一附属医院　深圳市第二人民医院烧伤整形科，深圳　　518035

基金项目:

国家自然科学基金面上项目 81772077

广东省自然科学基金面上项目 2019A1515011233

详细信息

通讯作者:
郇京宁，Email：jnhuan@sina.com

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出版历程
- 收稿日期: 2022-03-23

Inspiration from the research advances in microcirculatory dysfunction to the treatment of burn shock and burn septic shock

Huan Jingning^,,
Zhang Lijun

Department of Burn and Plastic Surgery, Shenzhen Second People's Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen 518035, China

Funds:

General Program of National Natural Science Foundation of China 81772077

General Program of Natural Science Foundation of Guangdong Province of China 2019A1515011233

More Information

Corresponding author: Huan Jingning, Email: jnhuan@sina.com

摘要

摘要: 微循环障碍是休克重要的病理生理变化。近10年来，许多有关微循环障碍机制的研究都涉及血管内皮细胞糖萼损害、大循环-微循环失偶联、血管低反应性以及微循环监测等方面。据此，该文讨论如何将这些研究结果应用于烧伤患者，目的是提醒临床医师在烧伤休克和烧伤脓毒症休克治疗过程中关注微循环改善情况，维持血流动力学的协调性。此外，随着精准、可靠的微循环监测技术的发展，有必要开展多中心的临床研究，以揭示大循环和微循环指标相结合的目标导向性休克复苏方案的临床意义。
- 烧伤 /
- 休克 /
- 微循环障碍 /
- 烧伤脓毒症休克 /
- 血管内皮细胞糖萼损害 /
- 血管低反应性
Abstract: Microcirculatory dysfunction is an important pathophysiological change of shock. In the last decade, many researches on the mechanism of microcirculatory dysfunction have been involved in areas such as the glycocalyx damage of vascular endothelial cells, macrocirculation- microcirculation discoupling, vascular hyporeactivity, and microcirculation monitoring. Accordingly, this paper discussed how these research findings can be applied to burn patients, with the aim of alerting the clinicians to improving microcirculation, and maintaining hemodynamic coordination during the treatment of burn shock and burn septic shock. In addition, with the development of accurate and reliable microcirculation monitoring techniques, it is necessary to carry out multi-center clinical trials to reveal the clinical significance of target-oriented shock resuscitation protocol combining macrocirculatory and microcirculatory parameters.
- Burns /
- Shock /
- Microcirculatory dysfunction /
- Burn septic shock /
- Glycocalyx damage of vascular endothelial cells /
- Vascular hyporeactivity
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脱细胞真皮基质（ADM）	重症监护病房（ICU）	动脉血氧分压（PaO₂）
丙氨酸转氨酶（ALT）	白细胞介素（IL）	磷酸盐缓冲液（PBS）
急性呼吸窘迫综合征（ARDS）	角质形成细胞（KC）	反转录-聚合酶链反应（RT-PCR）
天冬氨酸转氨酶（AST）	半数致死烧伤面积（LA50）	全身炎症反应综合征（SIRS）
集落形成单位（CFU）	内毒素/脂多糖（LPS）	超氧化物歧化酶（SOD）
细胞外基质（ECM）	丝裂原活化蛋白激酶（MAPK）	动脉血氧饱和度（SaO₂）
表皮生长因子（EGF）	最低抑菌浓度（MIC）	体表总面积（TBSA）
酶联免疫吸附测定（ELISA）	多器官功能障碍综合征（MODS）	转化生长因子（TGF）
成纤维细胞（Fb）	多器官功能衰竭（MOF）	辅助性T淋巴细胞（Th）
成纤维细胞生长因子（FGF）	一氧化氮合酶（NOS）	肿瘤坏死因子（TNF）
3-磷酸甘油醛脱氢酶（GAPDH）	负压伤口疗法（NPWT）	血管内皮生长因子（VEGF）
苏木精-伊红（HE）	动脉血二氧化碳分压（PaCO₂）	负压封闭引流（VSD）