PDF(Pubmed)
Abstract：
Source control is defined as the physical measures undertaken to eliminate the source of infection and control ongoing contamination, as well as restore anatomy and function at the site of infection. It is a key component of the management of patients with sepsis and septic shock and one of the main determinants of the outcome of infections that require source control. While not all infections may require source control, it should be considered in every patient presenting with sepsis; it is applicable and necessary in numerous infections, not only those occurring in the abdominal cavity. Although the biological rationale is clear, several aspects of source control remain under debate. The timing of source control may impact outcome; early source control is particularly relevant for patients with abdominal infections or necrotizing skin and soft tissue infections, as well as for those with more severe disease. Percutaneous procedures are increasingly used for source control; nevertheless, surgery-tailored to the patient and infection-remains a valid option for source control. For outcome optimization, adequate source control is more important than the strategy used. It should be acknowledged that source control interventions may often fail, posing a challenge in this setting. Thus, an individualized, multidisciplinary approach tailored to the infection and patient is preferable.
摘要：
源头控制被定义为为消除感染源和控制持续污染而采取的物理措施。以及恢复感染部位的解剖结构和功能。它是败血症和败血性休克患者管理的关键组成部分，也是需要源控制的感染结局的主要决定因素之一。虽然并非所有感染都需要源控制，它应该被考虑在每一个患者出现败血症;它是适用的和必要的在许多感染,不仅发生在腹腔。尽管生物学原理很明确，源代码控制的几个方面仍在争论中。源头控制的时机可能会影响预后；早期源头控制对于腹部感染或坏死性皮肤和软组织感染的患者尤其重要。以及那些患有更严重疾病的人。经皮手术越来越多地用于源控制；尽管如此，针对患者和感染量身定制的手术仍然是源头控制的有效选择。对于结果优化，充分的源代码控制比使用的策略更重要。应该承认，源头控制干预措施可能经常失败，在这种环境中构成挑战。因此，一个个性化的，针对感染和患者量身定制的多学科方法是优选的。
