Introduction
Septica is a life-threatening organ function disorder caused by a disorder in the body ‘ s response to infection and is a common and serious clinical condition. It is characterized by high morbidity and mortality rates, which pose a serious threat to the life and health of patients. Understanding the treatment of sepsis infections and analysing relevant cases are important for a better response to the disease.
Treatment of sepsis infections
(i) Anti-infection treatment
1. Early empirical antibiotics treatment
Once the sepsis has been diagnosed, it should begin to use antibiotics at the first time and, to the extent possible, the specimens should be taken for pathological examination before using antibiotics. Based on the source of infection, possible pathogens and local epidemiological data, broad spectrum antibiotics that can cover potential pathogens are selected. For example, for community access to sexually transmitted infections, there may be a need to consider, for example, pneumocococcus, yellow grapes, etc., the use of joint Great Entire ester antibiotics such as headgillin, and for hospital access to sexually transmitted infections, the use of resistant bacteria such as methylenedioxysilincin yellow fungus (MRSA) and multi-drug-resistant gland cactin, and so on may be required.
2. Targeted antibiotics treatment
After the return of pathogen results, the target treatment should be adjusted in a timely manner, i.e., the selection of sensitive antibiotics based on the results of drug-sensitive tests to reduce unnecessary antibiotics use and reduce the risk of drug resistance and the adverse effects of drugs. At the same time, attention should be paid to the dose and treatment of antibiotics, which typically last 7-10 days for patients with severe sepsis, but may require an extension of treatment in exceptional cases where it is difficult to remove the infection.
(ii) Liquid recovery
People with sepsis often have insufficient effective circulation capacity, and liquid recovery is a key measure to improve tissue injection. Crystal fluids such as physico-saline water, balanced salt solution are commonly used as resuscitation liquids. In the recovery process, indicators such as blood pressure, heart rate, urine and central intravenous (CVP) are closely monitored. Early Target-oriented Treatment (EGDT) requires CVP 8 – 12 mmHg, average arterial pressure (MAP) 65 mmHg, urine > 0.5 ml/(kg H), central intravenous oxygen saturation (ScvO2) > 70% or mixed intravenous blood saturation (SvO2) > 65%. At the same time, care should be taken to avoid overloading of liquids and to avoid complications such as pulmonary oedema.
(iii) Application of angiogenesis
Angularly active drugs are needed when the blood pressure is not normal after the liquid recovery. The commonly used vascularly active drugs include detoxin, dopamine, etc. Adrenalin is the preferred drug, which can improve blood pressure by constricting the blood vessels and improve the injection of vital organs. During the use of vascularly active drugs, blood pressure is continuously monitored through the arterial tube and the dose is adjusted to the changes in blood pressure.
(iv) Controlling sources of infection
In the case of sepsis, such as abdominal sepsis, skin soft tissue infections, etc., which is clearly infected, timely measures should be taken to control the source of the infection. This may include abscess surgeries, start-up surgery, etc. For example, in cases of abdominal sepsis, a perforation can be induced by ultrasound or CT, and in cases of serious intestinal perforation-induced perimenitis, timely surgical repair and abdominal rinsing are required.
(v) Organ function support
1. Respiratory support
People with sepsis may experience acute respiratory distress syndrome (ARDS), requiring respiratory support measures such as oxygen therapy, no or no. During mechanical ventilation, a pulmonary-protective ventilation strategy, such as small-tide (6 – 8 ml/kg) ventilation, and appropriate pneumatic pneumatic pressure (PEEP) setup, is used to reduce respiratory-related lung damage.
2. Renal support
Some patients suffer acute kidney damage and for those with less or no urine, liquid management can be carried out with close monitoring and, if necessary, renal substitution treatment such as continuous renal substitution treatment (CRRT) to remove toxins and excess water from the body and maintain internal environmental stability.
III. Analysis of relevant cases
(i) Case I
Patient, male, 65 years old. Heating, breathing difficulties, blurring consciousness after lung infections 2 days of admission. Body temperature: 39 °C, breath rush, 35 minutes, blood pressure 80/50 mmHg, heart rate 120 %, respiratory and wet voice. Laboratory examination: White cell count 22 x 109/L, neutral particle cell ratio 90%, calcium reduction (PCT) 10 ng/ml, blood lactation 5 mmol/L. Diagnosed as sepsis, infectious shock, ARDS.
Treatment programme: immediate liquid recovery, rapid retrenchment using physicosal water, and empirical use of ULA for infection. Blood pressure remains low after 2 hours of liquid recovery, and is maintained with adrenaline. Patients have a combination of oxygen, and mechanical ventilation is given to the tube intubation, using a small-tide air-transmission strategy. After six hours of treatment, the patient’s blood pressure stabilized, reaching 10 mmHg and ScvO2 72%. On the third day of treatment, the stinging results showed that the bacterium was non-activated for Bowman and adjusted to the pharmacinone/shubattan jointmino cycline for infection. After two weeks of active treatment, the patient ‘ s condition has gradually improved, with successful de-alerting, re-energizing and moving out of the intensive care ward.
(ii) Case II
Patient, female, 48 years old. High fever, increased abdominal pain and a one-day lack of urine following an emergency operation due to cholesterol inflammation, cholesterol piercing. Body: Body temperature 39.2°C, blood pressure 75/45 mmHg, heart rate 130 times/min, full abdominal pressure, anti-jump pain, muscle stress. Laboratory examination: White cell count 25 x 109/L, neutral particle-to-cell ratio 92%, blood acetic anhydride 250 μmol/L, PCT 15 ng/ml, blood lactation 6 mmol/L. Diagnosed as sepsis, infectious shock, acute kidney damage.
Treatment programme: First liquid resuscitation, combined with the use of aminobenan/sitatine against infection. There was no significant increase in the urine of the patient during the liquid recovery process and an oedema was found, taking into account the overload of the liquid. After keeping blood pressure stable, CRT treatment started. On the second day of the operation, the abdominal cavity was punctured with an ultrasound guide, which led to the release of large quantities of septic fluid. After active treatment, the patient’s blood pressure is stable, the kidney function is gradually restored and he/she is discharged after three weeks.
(iii) Case III
Patient, male, 72. Heat, cold war, and mental discomfort after diabetes ulcer infection. Body: Body temperature 38.8°C, blood pressure 90/60 mmHg, heart rate 100 times/min, red and impregnated ulcer on the lower left foot. Laboratory examination: White cell count 18 x 109/L, neutral particle cell ratio 88%, PCT 8 ng/ml, blood sugar 18 mmol/L. Diagnosed as sepsis, diabetes.
Treatment programmes: After the specimens have been taken, the empirical use of tungsten is resistant to infection, while insulin is given control of blood sugar. Diabetes ulcer has been completely emptied of the tissue. After one week of treatment, the patient has a normal temperature and the wound is reduced. Based on the subsequent growth results, it was golden septococcus and adjusted to be anti-infection with phenolin. After three weeks of comprehensive treatment, the ulcer gradually heals and sepsis is effectively controlled.
Conclusions
The treatment of sepsis infections is a complex and complex process requiring early identification, timely initiation of anti-infection treatment, reasonable liquid recovery, proper use of vascular active drugs, effective control of sources of infection and support for organ function. An analysis of cases shows that treatment programmes need to be individualized, depending on the source and the condition of the patient. Throughout the treatment process, close monitoring of changes in patients ‘ condition is essential to adjust treatment strategies, improve patient survival rates and improve post-natal planning. At the same time, the prevention of sepsis, such as the active treatment of infectious diseases and the strengthening of hospital infection control, are important measures to reduce its effects.
