重症脓毒症合并多器官功能障碍综合征的临床特征

目的探讨重症脓毒症合并多器官功能障碍综合征(MODS)的临床特征。方法比较重症脓毒症合并MODS病例与非重症脓毒症合并MODS病例。结果在根据同一入选标准入选的MODS病例中,重症脓毒症合并MODS者较非重症脓毒症合并MODS者的住院病死率与ICU病死率高,平均年龄大,住院时间和住ICU时间长,APACHEII分值高,呼吸机的使用频率高,体温高,呼吸频率快,血压低(包括收缩压、舒张压、平均动脉压),心率快,中性粒细胞百分比高,血红蛋白浓度高,血糖浓度高,白蛋白浓度低,动脉血氧分压低,氧合指数低,肺泡动脉氧分压差高,功能障碍器官个数多,MODS评分分值高,器官功能障碍的发生率高。以上比较,差异均有显著性(P<0.05)。结论重症脓毒症合并MODS者平均年龄大,病情更重,住院病死率和住ICU病死率更高。

Clinical characteristics of severe sepsis with multiple organ dysfunction syndrome

Objective To study the clinical characteristics of severe sepsis with multiple organ dysfunction syndrome (MODS). Methods The clinical data were collected and compared between patients with severe sepsis and MODS and non-severe sepsis with MODS. Results Those with severe sepsis had following characteristics, compared with patients with non-severe sepsis with MODS,the mortality at admission and the mortality in ICU were higher,the mean age was older, the days for admission and in ICU were longer, the scores of APACHE II were higher, the usage frequency of ventilatio was were more frequently, the body temperature and respiration higher, the blood pressure was lower (including SBP, DBP, and MAP), the heart rate and the percent rate of neutrophilic granulocyte were higher,the ferrohemoglobin and the blood sugar were higher, the albumin and arterial oxygen pressure were lower,the PO_2/SO_2 was lower,the A-aDO_2 was higher, the numbers of dysfunctional organs were more, the scores of MODS scores were higher, and the incidence of organ dysfunction was higher in patients with severe sepsis and MODS. All above comparisons showed significant difference (P<0.05). Conclusion Patients with severe sepsis and MODS,were older, the clinical conditions were more severe, and the mortality at admission and in ICU were higher.