多器官功能障碍综合征发病过程的临床研究

目的：探讨多器官功能障碍综合征（ＭＯＤＳ）的发病过程、临床特征及转归。方法：对一个综合性ＩＣＵ中连续发生的１１０例ＭＯＤＳ患者进行回顾分析。结果：２３．６％的患者表现为单相速发型，７６．４％为双相迟发型（Ｐ＜０．０１）。全部患者都发生了全身炎性反应综合征（ＳＩＲＳ）。两种类型ＭＯＤＳ的病死率分别为３０．８％和４４．１％（Ｐ＞０．０５），总病死率４０．９％。存活组与死亡组比较，全身性严重感染或感染性休克发生率、人均受累脏器个数及受累脏器功能分期均有显著差异。结论：ＭＯＤＳ发病过程表现为两种类型，以双相迟发型为多。两种类型的病死率无显著差异。全身性严重感染或感染性休克、受累脏器个数及功能失常的程度对预后有重要影响

Clinical characteristics of patients with multiple organ dysfunction syndrome

Objective:To investigate the pathogenic process,clinical characteristics and outcome of multiple organ dysfunction syndrome (MODS).Methods:A retrospective analysis was made in 110 patients with MODS occurred consecutively in a general ICU.Results:23 6% cases manifested as anticipated monophasic type,and 76 4% as delayed diphasic type ( P <0 01).All patients met the criteria of SIRS.The mortality of the two types were 30 8% and 44 1%,respectively ( P >0 05),and the total mortality was 40 9%.The incidence rate of severe sepsis or septic shock,the mean number of involved organs,and the severity of organ dysfunction were lower in survival group in comparison with that of the died group.Conclusions:The pathogenic process of MODS in this group manifests as two types,but most patients manifest as delayed diphasic type,no significant difference in mortality could be found between these two types.Severe sepsis or septic shock,the number of involved organs and the severity of organ dysfunction are important factors affecting the outcome of MODS.