摘要
自1969年Skillman对危重外科手术患者术后出现多器官衰竭综合症(MOF)描述以来,对严重创伤、败血症及休克患者的MOF的发生屡有报导。由于其有较高的死亡率,已引起医学界的高度重视。本文对我科收入的84名急诊重症中发生的MOF进行临床分析,以期提高对本病发生。
Eighty four cases of MOF which developed in emergency patienls were sorted out as: 38 cases due to infectious shock(IS); 30, coronary heart disease (CHD) or cot pulmonle (CP); 10, post operative shock (POS) and 6, posthemorrhagic shock (PHS). The mean happening time (MHT) of MOF in IS (2,7 days) and POS (1.8 days) was earlier than that in MHT of POS (8.5 days). The earliest failure organ (EFO) in IS was lung mostly, as where in PHS, POS EFO was liver, in CHD CP were heart and lung. The highest death rate was in OHD (91.6%). The mechanism of MOF was studied on the basis of cellular and subcellular investigation (the injury to receptors of enzyme system, the loss of membranous stability, the increase in Ca^(++) influx and the production of free radicals). For the prevention and early treatment of MOF clinical and laboratory monitorings were emphasized. Therapeutic measures including the stabilization of internal circumstances, to elevate organs' perfusion, the improvemnt of blood rheology, lessening of pulmonary load, access of respiration, increase in cardiac output and renal blood flows, ablition of infectious foci and general nutrional support and drugs to protect the mitochondrial functions should be taken.
出处
《解放军医学院学报》
CAS
1989年第1期22-24,共3页
Academic Journal of Chinese PLA Medical School
