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中华重症医学电子杂志 ›› 2016, Vol. 02 ›› Issue (03) : 184 -188. doi: 10.3877/cma.j.jssn.2096-1537.2016.03.010

所属专题: 重症医学 文献

观点

-正方观点-早期目标指导治疗:不应全盘否定其意义及作用
王陆豪, 欧阳彬, 管向东   
  • 收稿日期:2016-07-18 出版日期:2016-08-28
  • 通信作者: 管向东

Early goal directed therapy: couldn′t be not fully denied

Luhao Wang, Bin Ouyang, Xiangdong Guan   

  • Received:2016-07-18 Published:2016-08-28
  • Corresponding author: Xiangdong Guan
  • About author:
    Corresponding author: Guan Xiangdong, Email:
引用本文:

王陆豪, 欧阳彬, 管向东. -正方观点-早期目标指导治疗:不应全盘否定其意义及作用[J]. 中华重症医学电子杂志, 2016, 02(03): 184-188.

Luhao Wang, Bin Ouyang, Xiangdong Guan. Early goal directed therapy: couldn′t be not fully denied[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2016, 02(03): 184-188.

早期目标指导治疗(early goal directed therapy,EGDT)近年来受到不断质疑,针对其的三项研究ProCESS、ProMISe、ARISE结果均指向EGDT应被推翻。然而EGDT多年来推广和执行效果有目共睹,有效地降低了脓毒症患者的病死率;这三项大型研究其本身也存在着问题,并不能完全否定EGDT;我们正确地理解EGDT,在EGDT理念的基础上对其监测进行更新,才更有利益感染性休克患者的治疗。EGDT不应被抛弃,而应该进一步发展和更新。

Early goal-directed therapy had been doubted since it was reported 2001, and recently the trio of EGDT trials (ProCESS, ProMISe and ARISE) proved EDGT did not have positive effect and EGDT should not be recommended. However, the trio of EGDT trials themself had their own problem, they could not totally overthrow EGDT. Moreover, since EGDT was published and SSC bundle wide spread all over the world, it decreased the mortality of sepsis significantly. So we should understand EGDT correctly, knowing its core was the idea of early active resuscitated and updated its parameters, which could more conducive to patient with sepsis. EGDT should not be abandoned.

表1 近年来主要研究前后脓毒症及感染性休克患者病死率变化
表2 方法学上的差异
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