标准·方案·指南
ENGLISH ABSTRACT
儿童脓毒性休克管理专家共识(2025)
中华医学会儿科学分会急救学组
中华医学会急诊医学分会儿科学组
中华儿科杂志编辑委员会
作者及单位信息
·
DOI: 10.3760/cma.j.cn112140-20241106-00794
Expert consensus on the management of pediatric septic shock (2025)
The Subspecialty Group of Emergency Medicine, the Society of Pediatrics, Chinese Medical Association
the Subspecialty Group of Pediatrics, the Society of Emergency Medicine, Chinese Medical Association
the Editorial Board, Chinese Journal of Pediatrics
Wang Ying
Qian Suyun
Liu Chunfeng
Authors Info & Affiliations
The Subspecialty Group of Emergency Medicine, the Society of Pediatrics, Chinese Medical Association
the Subspecialty Group of Pediatrics, the Society of Emergency Medicine, Chinese Medical Association
the Editorial Board, Chinese Journal of Pediatrics
Wang Ying
Department of Pediatric Intensive Care Unit, Shanghai Children′s Medical Center, Shanghai Jiao Tong University School of Medicine, National Children's Medical Center, Shanghai 200127, China
Qian Suyun
Department of Pediatric Intensive Care Unit, Beijing Children′s Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
Liu Chunfeng
Department of Pediatric Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang 110004, China
·
DOI: 10.3760/cma.j.cn112140-20241106-00794
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摘要

脓毒性休克是导致重症感染患儿疾病进展甚至死亡的常见病因。近10年来,随着重症医学的发展,儿童脓毒性休克诊断及治疗方案不断优化。2024年2月起,中华医学会儿科学分会急救学组、中华医学会急诊医学分会儿科学组和中华儿科杂志编辑部组织国内儿科专家,在“儿童脓毒性休克(感染性休克)诊治专家共识(2015版)”基础上进行了更新及修订形成2025年版,以期更好地指导脓毒性休克患儿管理。

引用本文

中华医学会儿科学分会急救学组,中华医学会急诊医学分会儿科学组,中华儿科杂志编辑委员会. 儿童脓毒性休克管理专家共识(2025)[J]. 中华儿科杂志,2025,63(03):220-229.

DOI:10.3760/cma.j.cn112140-20241106-00794

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脓毒症是严重威胁儿童健康的重大疾病之一,世界儿童健康和死亡预防监测网络的调查显示,2016至2020年非洲和亚洲5岁以下儿童直接死亡原因中脓毒症居首位(36.7%) 1。全球范围内,儿童脓毒症每年发病人数约22例/10万,病死率4%~50% 2 , 3。国内研究显示,儿童重症监护室(pediatric intensive care unit,PICU)脓毒性休克患病率1.5%~5.2%,病死率18.3%~27.6% 4 , 5 , 6。2005年美国重症医学会(Society of Critical Care Medicine,SCCM)和世界儿童危重病协会首次确定了儿童脓毒症相关概念和定义 7,次年中国儿童重症医学专家发表了“儿科感染性休克(脓毒性休克)诊疗推荐方案(2006)”,在此基础上于2015年制订了“儿童脓毒性休克(感染性休克)诊治专家共识(2015版)” 8,成为国内儿科医师临床诊疗的重要参考。2020年国际“拯救脓毒症运动”组织(Surviving Sepsis Campaign,SSC)发布了“儿童脓毒性休克和脓毒症相关器官功能障碍管理国际指南”(以下简称“SSC指南2020”) 3。随着2016年成人脓毒症3.0版本定义和诊断标准的修订和推广 9,2024年SCCM颁布了“儿童脓毒症及脓毒性休克诊断标准”(以下简称新标准) 10。因此历经10年,随着国内外研究的深入和国际指南的修订,对儿童脓毒性休克病理生理改变有了更深入的理解,血流动力学治疗、器官功能支持及机体反应调节等也需要不断优化,基于此中华医学会儿科分会急救学组、中华医学会急诊医学分会儿科学组和中华儿科杂志编辑委员会组织对2015版专家共识进行更新、修订。
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备注信息
A

国际实践指南注册与透明化平台(PREPARE-2024CN293)

B
王莹,国家儿童医学中心 上海交通大学医学院附属上海儿童医学中心重症医学科,上海 200127,Email: nc.defudabe.umshsucip_gnawy
C
钱素云,国家儿童医学中心 首都医科大学附属北京儿童医院重症医学科,北京 100045,Email: mocdef.3ab611121naiqys
D
刘春峰,中国医科大学附属盛京医院重症医学科,沈阳 110004,Email: mocdef.labiamtoh852uilhz
E
中华医学会儿科学分会急救学组, 中华医学会急诊医学分会儿科学组, 中华儿科杂志编辑委员会. 儿童脓毒性休克管理专家共识(2025)[J]. 中华儿科杂志, 2025, 63(3): 220-229. DOI: 10.3760/cma.j.cn112140-20241106-00794.
F
所有作者声明无利益冲突
G
国家重点研发计划 (2021YFC2701800)
首都临床诊疗技术研究及转化应用 (Z211100002921063)
辽宁省重大科技专项 (2020JH1/10300001)
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