心脏围术期多系统器官衰竭的治疗和预后

目的：探讨心脏围术期呼吸、循环、肾功能衰竭的多系统器官衰竭的治疗和预后。方法：心脏术后3个以上系统器官衰竭患者29例，其中呼吸、循环、肾功能衰竭患者22例。给予解除病因，改善循环，呼吸机辅助，血液透析，预防感染等措施，持续监测患者血流动力学指标，生命体征，实验室检查等。结果：29例中22例呼吸、循环、肾功能衰竭患者有11例治愈出院，治愈率50％，剩下18例患者仅1例治愈出院，死亡17例，总死亡率58.6%。结论：及早解除病因，有效呼吸机辅助，改善循环及早血液透析和预防感染是降低心脏围术期呼吸、循环、肾功能衰竭患者死亡率的关键。

Treatment and outcome of multiple system organ failure during pericardiac-operation

Observe the treatment of multiple system organ failure (MSOF) involving respiratory and circulatory systems and kidney during peri-cardiac-opration. Methods: Twenty-nine patients suffering form MSOF involving three or more system organ were studied, including twenty-two patients suffering from the failure of respiration, circulation and kidney. The measures of treatment included releasing causes of MSOF, preventing infection, improving circulation, mechanical ventilation support and hemodialysis. The patients' vital signs and hemodynamics were continuously monitored and laboratory examinations were performed. Results: Eleven patients among these twenty-two patients suffering from the failure of respiration, circulation and kidney were cured and one patient among the other eighteen patients recovered and were discharged from hospital. Seventeen patients died. The total morality was 58.6% . Conclusions: Early releasing causes of MSOF, effective mechanical ventilation support, improving circulation, early hemodialysis are the key points of treatment.