老年多器官衰竭首发器官及序贯分析

目的 随访研究老年多器官衰竭(MOFE)首发器官及序贯发生规律,为临床早期诊断和治疗及二级、三级预防提供科学依据.方法 回顾性分析发生MOFE 153例患者的临床资料,用1:3配比病例对照随访研究方法进行分析.结果 153例MOFE患者发生诱因以感染为首位占89.5%(137/153),其中肺部感染占93.4%(128/137).纵向百分比首衰器官为肺(39.0%,60/154),其次为心(19.5%,30/154)、中枢(14.9%,23/154)、肾(10.4%,16/154)、胃肠(8.4%,13/154)、肝(6.5%,10/154)等;横向百分比首衰器官为肺(42.9%,60/140)、心(40.9%,56/137)、肾(32.6%,30/92)、中枢(21.9%,23/105)、胃肠(14.5%,9/62)等.首衰器官由短到长生存时间分别为肺、中枢、心、肾.结论 MOFE多为肺首衰.器官序贯衰竭顺序为肺、心、脑、肾等.

Analysis of the first failure organ and sequential failure on mutiple organ failure in the elderly

Objective To provide a scientific basis for early clinical diagnosis and treatment as well as secondary and tertiary protection through 10 years inquiry of multiple organ failure in the elderly(MOFE).Results Among 153 MOFE cases,the first inducement of 89.5%(137/153) patients was infection,among which 93.4% (128/137) was pulmonary infection.The vertical percentage of the first failure organ was as follows: pulmonary (39.0%,60/154),heart (19.5%,30/154),brain (14.9%,23/154),kidney (10.4%,16/154),alimentary canal (8.4%,13/154),liver (6.5%,10/154);while the horizontal percentage was as follows: pulmonary (42.9%,60/140),heart (40.9%,56/137),kidney (32.6%,30/92),brain (21.9%,23/105),alimentary canal ( 14.5%,9/62).The survival time of the first organ failure from shortness to length was as follows: pulmonary,brain,heart,kidney.Conclusions Most MOFE cases have pulmonary failure at first.The organs failure sequence is pulmonary,heart,brain and kidney in order.