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重症急性胰腺炎与全身炎症反应综合征 总被引:1,自引:0,他引:1
重症急性胰腺炎(SAP)是引起全身性炎症反应综合征(SIRS)的常见原因,从SIRS到多器官功能不全综合征(MODS)是一个渐进的过程,早期评估SAP的预后在SAP的诊治过程中具有指导性意义,早期积极有效地阻断SIRS向MODS的进程、保护重要脏器,则可提高SAP的治愈率。 相似文献
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高景利 《中华临床外科杂志》2004,12(3):1048-1050
多脏器功能不全综合征(MODS)发病机制错综复杂,临床表现多种多样,治疗难度大,预后差。胸部创伤发生MODS有其特点,如何早期识别、预防及治疗,对预后有着重要的意义。为此,笔者对25例胸部创伤后MODS患者综合分析如下。 相似文献
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重症急性胰腺炎与全身炎症反应综合征 总被引:1,自引:0,他引:1
重症急性胰腺炎(SAP)是引起全身性炎症反应综合征(SIRS)的常见原因,从SIRS到多器官功能不全综合征(MODS)是一个渐进的过程,早期评估SAP的预后在SAP的诊治过程中具有指导性意义,早期积极有效地阻断SIRS向MODS的进程、保护重要脏器,则可提高SAP的治愈率。 相似文献
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炎性介质与SIRS、CARS、MODS和CBP治疗 总被引:6,自引:0,他引:6
近年来研究证明机体的炎症细胞被各种损伤过度激活后产生大量的炎性介质,导致机体炎症反应失控是发生全身性炎症反应综合征(SIRS)、代偿性抗炎反应综合征(CARS)和多器官功能障碍综合征(MODS)的重要环节,而早期控制炎症反应,阻断其发展或有效清除循环中的炎性介质可能是防治SIRS和MODS的关键。因此,近年来研究连续性血液净化(CBP)对机体炎性介质的清除也成为一个热点。 相似文献
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MODS大鼠胸腺树突状细胞病理改变及作用研究 总被引:1,自引:1,他引:0
目的探讨树突状细胞在多脏器功能障碍综合征(MODS)发病机制中的作用,为严重创伤后脓毒症和MODS的基础研究与临床防治提供新的思路.方法运用光镜、电镜观察与免疫组化(CD1a、S-100)及TUNEL标记方法证实并研究了MODS大鼠胸腺中树突状细胞的变化及其与细胞凋亡的关系.结果MODS早期,胸腺树突状细胞增生和过高反应,伴淋巴细胞大量凋亡;在MODS期,树突状细胞数量减少形态萎缩,淋巴细胞凋亡减轻.结论树突状细胞是MODS的早发病变和启动因素之一,可能是影响全身炎症反应综合征(SIRS)或代偿性抗炎反应综合征(CARS)的形成和转归,使病程走向MODS的一个重要原因. 相似文献
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近年来.急性胰腺炎的发病率正在上升,其中重症姨腺炎约占5%~15%。由于治疗方法的改进,病程早期病死率已有下降,后期常可并发多器官功能障碍综合征(Multiple Organ Dysfunction Syndrome MODS),最终导致多器官功能衰竭(Multiple Organ Failure MOF).成为本病的主要死因,也是本病病死率居高不下的原因。本文谨对重症脯腺炎后MODS的临床特点及防冶进行讨论。 相似文献
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中性粒细胞凋亡在高容量血液滤过防治多器官功能障碍中的变化及意义 总被引:6,自引:2,他引:4
多器官功能障碍综合征(MODS)是重症监护室患者死亡的主要原因之一。我们在建立猪MODS模型的基础上,采用高容量血液滤过(HVHF)防治MODS.通过观察中性粒细胞(PMN)凋亡在HVHF防治MODS中的变化及意义,为临床HVHF防治MODS提供新的实验依据。 相似文献
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目的 总结经皮肾镜碎石(PCNL)术中冲洗液外渗并发多脏器功能障碍综合征(MODS)的诊断及治疗方法.方法 报道本院2例患者PCNL术后发生MODS诊治经过.例1术中肾盂黏膜穿孔大量冲洗液外渗,术后继发MODS,经切开引流、输蛋白利尿等方法处理后好转.例2因术中冲洗液外渗,出血性休克继发MODS,经DSA栓塞、连续性肾脏替代治疗(CRRT)、抗感染治疗后好转.结果 2例患者MODS均控制,重要脏器功能基本恢复.结论 术中干预可以防止PCNL术中冲洗液外渗MODS的发生,术后早期采取综合治疗措施可以促进重要脏器恢复. 相似文献
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全身炎症反应综合征调控与多器官功能不全综合征防治 总被引:2,自引:1,他引:1
1991年美国胸科医师和危重病医学联席会议明确全身炎症反应综合征 (systemicinflammatoryresponsesyndrome ,SIRS)和多器官功能不全综合征 (multipleorgandysfunctionsyndrome ,MODS)的概念[1] ,炎症反应学说成为MODS的基石。机体炎症反应的转归取决于促炎—抗炎反应平衡 ,任何一方的过度优势均可以损害机体 ,成为MODS的基础。早期干预SIRS ,积极防治MODS ,是降低危重病患者病死率的重要手段。一、积极治疗原发病严重创伤、休克、感染、复苏延迟、大量坏死组织存留均为SIRS诱发因素 ,与MODS的发生、发展密不可分 ,因此原发病的… 相似文献
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Burd A 《Burns : journal of the International Society for Burn Injuries》2012,38(1):142; author reply 143
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Doxey G 《The Journal of orthopaedic and sports physical therapy》1984,5(6):336-347
The purpose of this review is to outline methodology for assessing body composition utilizing anthropometric and densitometric techniques. The objective of body composition assessment is to measure body fat and lean body mass. The quantity of these components varies due to growth, physical activity, dietary regimens, and aging. Anthropometric techniques incorporate selected skinfolds, circumferences, skeletal widths, or other variables to estimate body composition within k2.0-4.0%. These techniques are adequate for field testing of groups or individuals, but are population specific. Densitometry measures body volume irrespective of physique, sex, or age. This laboratory technique estimates body composition within 1.0-2.0%, is more difficult to administer, but is not population specific. Some limitation exists with any present technique due to biological variability and incomplete research of reference body composition in children, females, and the aged. J Orthop Sports Phys Ther 1984;5(6):336-347. 相似文献
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Subramaniam B Pomposelli F Talmor D Park KW 《Anesthesia and analgesia》2005,100(5):1241-7, table of contents
We performed a retrospective review of a vascular surgery quality assurance database to evaluate the perioperative and long-term morbidity and mortality of above-knee amputations (AKA, n = 234) and below-knee amputations (BKA, n = 720) and to examine the effect of diabetes mellitus (DM) (181 of AKA and 606 of BKA patients). All patients in the database who had AKA or BKA from 1990 to May 2001 were included in the study. Perioperative 30-day cardiac morbidity and mortality and 3-yr and 10-yr mortality after AKA or BKA were assessed. The effect of DM on 30-day cardiac outcome was assessed by multivariate logistic regression and the effect on long-term survival was assessed by Cox regression analysis. The perioperative cardiac event rate (cardiac death or nonfatal myocardial infarction) was at least 6.8% after AKA and at most 3.6% after BKA. Median survival was significantly less after AKA (20 mo) than BKA (52 mo) (P < 0.001). DM was not a significant predictor of perioperative 30-day mortality (odds ratio, 0.76 [0.39-1.49]; P = 0.43) or 3-yr survival (Hazard ratio, 1.03 [0.86-1.24]; P = 0.72) but predicted 10-yr mortality (Hazard ratio, 1.34 [1.04-1.73]; P = 0.026). Significant predictors of the 30-day perioperative mortality were the site of amputation (odds ratio, 4.35 [2.56-7.14]; P < 0.001) and history of renal insufficiency (odds ratio, 2.15 [1.13-4.08]; P = 0.019). AKA should be triaged as a high-risk surgery while BKA is an intermediate-risk surgery. Long-term survival after AKA or BKA is poor, regardless of the presence of DM. 相似文献
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Gómez-Arnau JI Aguilar JL Bovaira P Bustos F De Andrés J de la Pinta JC García-Fernández J López-Alvarez S López-Olaondo L Neira F Planas A Pueyo J Vila P Torres LM;Grupo de Trabajo de NVPO de la Sociedad Española de Anestesiología y Reanimación 《Revista espa?ola de anestesiología y reanimación》2010,57(8):508-524
Postoperative nausea and vomiting (PONV) causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV) may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Espa?ola de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1) Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2) Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3) Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1) who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach). 4) Dexamethasone, droperidol, and ondansetron (or other setrons) have similar levels of efficacy; drug choice should be made based on individual patient factors. 5) The drug prescribed for treating PONV should preferably be different from the one used for prophylaxis; ondansetron is the most effective drug for treating PONV. 6) Risk for PONV should be assessed before discharge after outpatient surgery or on the ward for hospitalized patients; there is no evidence that late preventive strategies are effective. 7) The drug of choice for preventing OINV is droperidol. 相似文献