老年腹部外科急症患者全身性炎症反应综合征和多器官功能不全综合征的临床分析

作者回顾性研究了２９２例老年腹部外科急症患者的全身性炎症反应综合征（ＳＩＲＳ）和多脏器功能不全综合征（ＭＯＤＳ）的临床资料，分析ＳＩＲＳ向ＭＯＤＳ的发展过程，探索ＭＯＤＳ的防治策略。结果：老年腹部外科急症患者入院时ＳＩＲＳ的发生率是４１．１％，其后ＭＯＤＳ的发生率是１４．２％，病死率是１１．７％。经治疗４８小时后（包括手术和保守治疗），仍伴有ＳＩＲＳ的病例中，４０．５％（１７／４２）发展为ＭＯＤＳ。２９２例老年腹部外科急症患者中，１９例发生ＭＯＤＳ（６．５％），１６例死亡（８４．２％），结论：早期诊断ＳＩＲＳ，特别注意分析治疗４８小时后仍伴有ＳＩＲＳ的患者的原因，积极调控机体炎症反应，才是改善老年腹部外科急症患者预后的关键

CLINICAL STUDY ON SYSTEMIC INFLAMMATORY RESPONSE SYNDROME AND MULTIPLE ORGAN DYSFUNCTION SYNDROME IN ELDERLY PATIENTS WITH SURGICAL ABDOMINAL EMERGENCY

To evaluate the process from systemic inflammatory response syndrome (SIRS) to multiple organ dysfunction syndrome (MODS) and probe the therapeutic strategies for elderly patients, we retrospectively studied the clinical data of SIRS and MODS in 292 elderly patients with surgical abdominal emergency. Results: On admission, the morbidity rate of SIRS was 41.1%. Afterwards the morbidity rate of MODS was 14.2%, and the mortality rate of the elderly patients with SIRS was 11.7%. After 48 hours of therapy, MODS was developed in 40.5% of the cases also with SIRS. Of all the 292 elderly patients, 19 cases (6.5%) developed MODS and 16 patients (84.2%) died. Conclusion: The outcome of the patients with surgical abdominal emergency may be improved if SIRS is early diagnosed, the cause of SIRS after 48 hours therapy is well defined and the body inflammatory response is properly regulated.