临床医学败血症周秀红ppt课件.ppt

Sepsis or septicemia in children;Definition;Gram stain positive coci Gram stain negative bacilli Anaerobic bacteria Fungi;virulence and quantity Exotoxin, Endotoxin Defense mechanism Immunologic function,age,etc Chronical diseases： Nephropathy,Liver sclerosis,Connective tissue diseases,Diabetes mellitus,Malignant tumor,and so on Medical factors： long-term Steriods,Antibiotics,All kinds of instrumentation such as invasive meauver,catheterization;More than one bacterium isolated in the same blood samples Associated with immnocompromised status Commonly occurs in patients with chronic diseases or use of immnodepressors;Clinical feature： endotoxemia and shock young baby is easy to suffer from sepsis, and deteriorate to MODS.it can be asymptomatic Blood test：WBC elavates or drops Metastatic foci：more commonly ;classification; Mechanism ;Metastatic foci： endocarditis,meningitis,oestoarthritis,and so on mulnutrition Disturbed hemostasis：such as acidosis Complications in organs:dysfunction;Clinial syndrome manefested with strong inflmmation over-responsiveness of inflmmatory mediators all over the body(cytokines Cascade） pathogenic factors： infection:bacteria,virus,… non-infection:injuries,burns,… outcome：organ and tissue injuries;Hypothesis associated with SIRS;Pathophysiology of SIRS ;Correlation of SIRS and etiology;principles： Antibiotics:Early,adequate,regulatory,combined and through vein Clear up the infected foca Regulate inflmmatory responsivesness Keep intestine clean Ameliorate microcirculation Rest, nutrition and supportive measures;Septic shock;Definition;Gram-negative bacilli： commonly,cold shock at early stage Gram-positive coci： warm shock;Mechanism;Mechanism －microcirculation dysfunction;Mechamism－over-responsiveness;kidney;Clinical manifestation;Clinical manifestation;Diagnosis;Clinical manefestation;pr