腹部外科疾病并发MODS的临床救治研究

目的 MODS是腹部外科疾病患者死亡的最直接、最重要的原因之一。本研究探索有效合理的综合临床救治方法。方法 ①短程大剂量山莨菪碱和地塞米松联用的综合治疗方法；②“分阶段代谢营养支持”治疗；③采用自制的“解毒固本冲剂”配合治疗；④针对“炎性介质、细菌、内外毒菌”等8个方面，的出了多环节兼顾和并治的12条综合治疗具体措施；⑤生长激素和生长抑素治疗等；⑥手术治疗等。结果 按KnausW.A教授MODS的诊断标准，118例中共死亡59例，病死率为50.00％。其中应用传统常规疗法的87例，死亡49例，病死率为56.32%。采用综合救治策略的31例中，共死亡10例，病死率为32.25%。结论 MODS病因复杂，治疗困难，死亡率高，采用综合救治新策略疗法能降低MODS的死亡率。

Clinic research and combined treatment of MODS as a complication of severe abdominal surgical conditions

Objective　There is no good way for the treating of mutiple　organ disfunction syndrom（MODS），at present so we want to find some combined treatment measures to cut down the death rate of the patients who suffer from abdominal surgical conditions complicated MODS．Methods　 ①Developing new treatment using a large dose of anisodaminum and dexamethasone together for a short time．②While treating MODS as a whole entity　inflammatory mediators，bacteria，exotoxin and endotosxin，immunity，dysfunction of microcirculation，nutrition and metabolism，underlying diseases，and the organ function should be considered and managed together．We also carry out 12 concrete teatment measures．③Under the circumstances that on the one hand，the　high metabolic rate　needs to be supported，on the other hand，the organ can’t effectively use the nutrients and get rid of the metabolites； we　provide nutritional support at different stages to minimize serious complications．④Using JIEDUGUBENTANG which was developed by ourselves，to improve immune dysfunction and regulate the inflammatory mediators．Results　Fifty eight out　of　116 patients died of MODS，mortality being 50.00%．Fouty nine of the 87 patients who were treated with conventional methods died，the mortality being 56.32%．Ten patients of the 31 patients who were treated with combined management measures died，the mortality being 32.25%．Conclusion　MODS have complex pathogensis are difficult to be cured，and have high mortality．The mortalities of MODS can be decreased by using new combined treatment strategy．