外科手术的感染教材教学稿件.ppt

Surgical Infection;; The pathogens causing surgical infections are frequently mixed, and usually originate from the patients own endogenous flora. These pathogens are opportunistic, often depending on an acquired epithelial defect to cause infection. ;Classification;According to pathogens;According to course;According to origination of pathogens;Other classification; Opportunistic infection Surperinfection Nosocomial infection (from hospital); Gram-negative bacteria have surface components (endotoxin or lipopolysaccharide) that are toxic. Gram-positive bacteria produce powerful exotoxins. ;Syndromes of the inflammatory response; Systemic inflammatory response syndrome ( SIRS ) Septicaemia Sepsis Septic shock; SIRS: The essential clinical findings were an abnormal body temperature, tachycardia, tachypnea, and an aberrant white blood cell count.; Sepsis: is the circumstance of a patient with findings consistent of SIRS and a documented infection. .; Severe sepsis: is defined as occurring when a patient with sepsis has critical organ dysfunction and hypo-perfusion including hypotension. .; Septic shock: is the most serious clinical problem and exists if a patient has severe sepsis, is resuscitated appropriately with intravenous fluid infusion, and remains in shock. .;Death rate :; Sepsis, severe sepsis, and septic shock can be further divided into subsets of confirmed infection and suspected infections unconfirmed by positive culture.;;Systemic inflammatory response syndrome;Pathophysiology: ; These systems include, but are not limited to, complement, cytokine cascades, arachidonic acid metabolites, cell-mediated immunity, the clotting cascade, and hormonal immune mechanisms. . ;Diagnosis of SIRS;Sepsis;Causes :; Patients with an intra-abdominal or pelvic source of infection usually have a history of antecedent conditions predis