摘要
目的:研究急性呼吸窘迫综合征诱发多器官功能衰竭高危因素及其综合治疗。方法:回顾性分析本院外科ICU(SICU)4年所收治15例ARDS患者临床资料。结果:本组病例中累及0个、1个、2个和3个及以上肺外器官功能衰竭的发生率分别为3/15(20％)、3/15(20％)、4/15(26.7％)和5/15(33.3％),其死亡率分别为0/3(0％)、1/3(33.3％)、2/4(50％)和5/5(100％);总死亡率为8/15(53.3％)。其中循环系统发生率最高,其它依次为肾、消化道、中枢神经系统、血液系统、肝。较低PaO_2/FiO_2、高APACHE-Ⅱ评分者死亡率相对较高。后期病人普遍存在贫血、低蛋白血症,但生存组(7例)血红蛋白含量血清白蛋白明显高于死亡组(8例)P<0.05)。结论:急性呼吸窘迫综合征的死亡率较高,成功治疗ARDS的关键是,充分认识高危因素:高APACHE-Ⅱ评分和较低PaO_2/FiO_2,及早采用综合治疗措施,防治多器官功能衰竭,以期降低急性呼吸窘迫综合征的死亡率。
Objective: To study high risk factors of multiple organ failure (MOF) induced by acute respiration distress syndrome (ARDS) and its general treatment. Methods: The clinical data of 15 patients with ARDS was reviewed retrospectively from October 1995 to January 1999 in surgical intensive care unit (SICU) of our hospital. Results: Of the 15 patients, the morbidity of 0,1,2,3 or more organs failure (excluding lungs) were 3/15(20%),3/15(20%),4/15(26. 7%) and 5/15(33. 3%)respectivly and their mortality were 0/3(%), 1/3(33. 3%), 2/4(50%) and 5/5(100%) respectively. The general mortality was 8/15 (53. 3%). Circulatory failure was the most common organ dysfunction and the morbidity of other organ failure such as kidney, gut, blood system, central nervous system and liver showed descending trend in turn. The mortality was higher in patients who had lower PaO2/FiO2 and higher APACHE- I score. Serum levels of Hgb and albumin in advanced patients of survival group were significantly higher than that of the death one (P<0. 05). Conclusion: The mortality of ARDS is higher. It is the key for treating ARDS successfully that to identify high risk factors such as higher APACHE- Ⅱ score and lower PaO2/ FiO2 and to manage MOF activ1ely.
出处
《中国微创外科杂志》
CSCD
2000年第1期41-44,共4页
Chinese Journal of Minimally Invasive Surgery
