急性缺血性脑卒中并多脏器功能障碍综合征因素分析

目的 分析急性缺血性脑卒中并多器官功能障碍综合征(MODS)患者的发生率、病死率及相关危险因素.方法 回顾性分析830例急性缺血性脑卒中中合并MODS 89例患者的临床资料.结果 本组MODS发生率为10.7%,死亡52例,病死率为58.4%.单因素结果分析显示:合并感染者的病死率高,病死率随着受累器官数目的增加而增加;经Logistic回归分析,既往健康状况、衰竭器官的数目、神经功能缺损的分值为主要死亡因素,高龄、病变部位靠近中线及基底动脉系统者、缺血灶体积大、病程早期高敏C反应蛋白明显增高者MODS的发生率高.结论 MODS多发生在急性缺血性脑卒中后2周内,提示MODS的防治除控制原发病外,还应对易受累脏器采取积极防治措施,尤其应加强全身综合治疗.

Analysis of acute cerebral arterial thrombosis with multiple organ dysfunction syndrome

Objective To investigate the incidence,case fatality and risk factors of acute cerebral arterial thrombosis complicated by multiple organ dysfunction syndrome(MODS).Methods A retrospective study was conducted in 830 patients with acute cerebral arterial thrombosis,among whom 89 also developed MODS.Results The incidence of MODS in these patients was 10.7% with case fatality of 58.4%.The presence of concurrent infection and increased number of organ involved both resulted in higher case fatality.The preceding health status,number of failing organs and score of neurologic impairment were the main fetal factors according to logistic regression analysis.Conclusion MODS usually occurs in two weeks after the onset of acute cerebral arterial thrombosis.Prevention of MODS involves rigorous treatment of the compromised organs and comprehensive systemic therapy in addition to the management of the primary diseases.