腹部外科多器官功能衰竭68例患者的救治

报道11年间明确诊断为腹部外科多器官功能衰竭(MOF)的患者68例,提出了腹部外科MOF的临床特点、触发因素、首发衰竭器官、各个脏器衰竭发生频度、死亡原因和病死率及MOF的预防和现代救治措施.资料分析结果显示,腹部外科MOF的触发因素为严重感染、败血症、重度多发伤和急诊腹部外科大手术等.腹部外科MOF治疗的关键是要切实做到早期识别、早期检查、早期诊断和早期治疗.救治结果存活17例,死亡51例.作者提出MOF一旦发病要给予强有力的“四大一支持”综合措施的新疗法.本组18例MOF患者实施“四大一支持”综合疗法,15例获救治成功,该疗法具有实用、有效的价值.

A REPORT OF 68 CASES OF MULTIPLE ORGAN FAILURE (MOF) IN ABDOMINAL SURGERY

Sixty-eight cases of multiple organ failure (MOF) developed after abdominal surgery over the past a decade were analysised for its clinical characteristics, obvious triggering factors, first involved organ, frequency of failure organs, causes of death and mortality, and particularly emphasing its prevention and modern treatment. The clinical observation showed that the triggering factors of abdominal-surgical MOF are severe infection,septicaemia , severe multiple system trauma, and post-operative complications. The key method of treatment is early diagnose and to stop its development. The best way is prevention. If MOF develops, a new combined therapy of short period of high doses anisodaminum;in large volume short period of high doses dexamethasonum in large volume;high doses in large volume of disinfectant antibiotics; high doses in large volume of abdominal cavity washing fluid and nu-tritional support plays a key role in the treatment. It is simple, practical and effective. In our series, 15 out of 18 cases thus treated were successfully salvaged.