重症评分在治疗有机氟气体中毒致多器官衰竭患者中的作用

目的 了解重症评分系统对治疗有机氟气体中毒导致多器官功能衰竭患者的作用.方法 采集3例工业有机氟气体中毒患者的临床病例,包括临床症状、体征、诊疗经过、预后,动态随访APACHEⅡ、SOFA、MODS评分,比较不同患者的差异并分析与预后相关性.结果 3例患者首日APACHEⅡ评分为19~26分;1例患者三项评分持续升高,构成比例不同,提示有不同脏器相继出现功能衰竭,预后不良;另2例患者3项评分进行下降,患者存活出院,无远期并发症.结论 可以采用多个评分系统综合评价有机氟气体中毒导致多器官功能衰竭患者转归病程,强调对此类患者给予整体评估和个体化治疗.有待建立有机氟中毒特异性的重症评分系统.

Critical Scoring Systems in the Treatment of Multiple Organ Dysfunction Due To Organic Fluorine Gas Poisoning

Objective To investigate the value of critical scoring system in the treatment of multiple organ dysfunction after exposure to poisoning by analyzing 3 cases of industrial organic fluorine gas poisoning. Methods Clinical data of symptoms,signs,treatments,outcome and the changes in the scores as APACHEⅡ,SOFA,MODS were collected,the differences among the patients were compared and the relevance was analyzed. Results The first APACHEⅡwas 19-26. Scores of case 1 in the three scoring systems constantly increased and different components were found, with the suggestion of sequential organ dysfunction. Other two patients' scores decreased and survived without complications. Conclusion Multiple critical scoring systems can be used to evaluate the outcome of multiple organ dysfunction due to organic fluorine gas poisoning. System evaluation and individualized treatment are both important. More studies can help to set up a special critical scoring system.