多发伤并发多器官功能障碍综合征的临床分析

目的调查分析多发伤患者并发多器官功能障碍综合征（MODS）的危险因素、发病率和病死率。方法回顾性分析2008年9月至2011年6月收住我院ICU的155例多发伤患者的临床资料。包括处理方法，损伤严重程度评分（ISS）分值与发生MODS的关系，发生MODS与未发生MODS病死率的比较。结果155例多发伤患者发生MODS29例（18．7％）。ISS〈16分、16～25分和≥25分的病例数分别为39、58和58例，其中发生MODS的病例分别为3、7和19例（x2=12．321，P=0．002），≥25分的MODS发生率较高。发生MODS的29例多发伤患者死亡15例，未发生MODS126例患者死亡28例（x2=10．236，P=0．001）。结论多发伤后并发MODS是患者死亡的重要原因。积极治疗原发性损伤，防止创伤治疗过程中的第二次打击，早期支持保护重要脏器功能是改善多发伤预后的关键。

Clinical analysis of multiple organ dysfunction syndrome in multiple trauma patients

Objective To investigate and analyze the risk factors, morbidity and mortality rates of multiple organ dysfunction syndrome （ MODS ） after multiple trauma. Methods The clinical data of all 155 patients with multiple trauma admitted to our ICU from Sep 2008 to Jun 2011 were retrospectively analyzed, including treatment,injury severity score（ISS） and its relationship with MODS. Results The morbidity of MODS among all 155 patients was 18.7% （29/155）. There were 3,7 and 19 patients died due to multiple trauma in 39 ISS 〈 16,58 ISS 16 - 25, and 58 ISS ≥ 25 cases respectively. The morbidity of MODS was significantly higher in patients with ISS ≥25 （ X2 = 12. 321, P = 0. 002 ） than in others. There were 15 eases with MODS and 28 cases without MODS died respectively in multiple trauma patients （ X2 = 10. 236, P = 0. 001 ）. Conclusion MODS is the important reason for death in multiple trauma patients. It is pivotal to actively deal with primary trauma to avoid the second insult to the patients and support vital organs early in order to improve the prognosis of multiple trauma.