肝硬化并发多脏器功能障碍综合征的临床特征及预后分析

目的探讨肝硬化并发多脏器功能障碍综合征(MODS)的临床特征及近期预后.方法对331例肝硬化患者进行回顾性分析,对47例符合MODS诊断标准的患者作序贯器官衰竭估计(SOFA)评分,并比较存活与死亡者的差异及临床特征.结果MODS的发生率为14.2%,与无MODS者比较,两者的病程、既往上消化道出血史差异有显著性(P＜0.05).47例MODS患者中好转26例,死亡21例,病死率44.7%;存活组与死亡组患者临床特征比较,两组年龄、MODS发生时间、受累器官个数、总最大SOFA评分差异有显著性;Spearman等级相关分析显示,总最大SOFA评分与昏迷、休克、少尿、胃肠道大出血等严重临床征象的存在有显著相关性.结论肝硬化并发MODS并非少见,且病情危重,预后不良.影响预后的主要因素有年龄、受累器官个数,MODS发生时间以及存在昏迷、休克、少尿、胃肠道大出血等危象.

Clinical characteristics and prognosis in the patients with multiple organ dysfunction syndrome complicated by cirrhosis

Objective To explore clinical characteristics and prognosis in the patients with multiple organ dysfunction syndrome (MODS) complicated by cirrhosis.Methods A retrospective analysis was applied in 331 pationts of cirrhosis. Sequential organ failure assessment (SOFA) score was used to measure prognosis in 47 patients with MODS.The differences of SOFA score and clinical characteristies were compared between survivors and nonsurvivors.Results The MODS rate was 14.2% in cirrhosis patients.There were significant differences in course of disease and hemorrhage history of uper gastrointestinal between MODS and non_MODS pationts (P<0.05).Out of 47cases with MODS, death occurred in 21 cases (44.7%).There were significat differences in age, time of MODS occurring ofter admission, number of organ lesion and total maximum SOFA scores between survivors and nonsurvivors.Total maximum SOFA scores had a direct relaltion with the signs of coma,shock,oliguria and serious gastrointestinal hemorrhage by Spearman's grade relation analyze.Conclusion The major factors affected prognosis of MODS are age, number of organ lesion, time of MODS occurring, and coma,shock,oliguria and serious gastrointestinal hemorrhage.