— 生理適應 · MEDIUM · MCQ —
一位病人正經歷敗血性休克。何項發現提示了組織灌流不足的潛在併發症？
A client is experiencing septic shock. Which finding indicates a potential complication of decreased tissue perfusion?
- ADecreased level of consciousness✓ 正解意識層次降低
- BHigh urine output尿量增加
- CWarm, flushed skin皮膚溫暖且潮紅
- DBounding pulse脈搏強而有力
— Explanation · 中文詳解 —
敗血性休克時，全身血管擴張及有效循環血量不足，會導致組織灌流不足。意識狀態改變（如嗜睡、混亂）是腦部灌流不足的表現，屬於嚴重併發症。早期敗血性休克可能表現為皮膚溫暖、脈搏強勁，但隨著病情進展，灌流不足會影響重要器官功能。
In septic shock, systemic vasodilation and inadequate effective circulating volume lead to tissue hypoperfusion. A change in level of consciousness (such as drowsiness or confusion) reflects inadequate cerebral perfusion and represents a serious complication. Early septic shock may present with warm skin and a bounding pulse, but as the condition progresses, hypoperfusion impairs vital organ function.
✦ 台美臨床差異
美國重症團隊在敗血性休克治療中，會早期使用血管加壓藥物（vasopressors）；台灣亦然，但藥物選擇與滴定速度可能因醫師習慣而異。