摘要
目的 :探讨多发伤与全身炎症反应综合征 (SIRS)、多器官功能障碍综合征 (MODS)的关系。方法 :96个多发伤患者按照SIRS诊断标准分为非SIRS组和SIRS组 (包括非感染性SIRS组 ,全身性感染组和感染性休克组 )。计算各多发伤患者的急性生理和慢性健康状况 (APACHEⅡ )评分 ,各组别SIRS、MODS的发生率和病死率 ,进行对比分析。结果 :全身性感染SIRS组 ,感染性休克SIRS组病死率及MODS的发生率均高于非感染性SIRS组 ,三者差异均有统计学意义 (P <0 .0 5 )。SIRS组MODS的发生率高于非SIRS组 ,两者差异有统计学意义 (P <0 .0 5 )。一旦发生MODS ,病死率均高于 5 0 %以上 ;APACHEⅡ评分越高 ,病死率越高。以颅脑损伤为主的多发伤患者 ,病死率最高 (P <0 .0 5 )。结论 :多发伤、SIRS到MODS是一个临床常见的渐进过程。早期发现SIRS并有效调控 ,控制继发感染 ,阻止其进一步发展 ,可能是降低MODS发生率和改善多发伤 ,尤其是重症患者预后的关键。
Objective: To investigate multiple trauma patients' relation to systemic inflammatory respons syndrome and multiple organ dysfunction syndrome.Methods: 96 multiple trauma patients were divided into two groups as followed:non-SIRS group,SIRS group(including unsepsis group,sepsis systemic infection group,septic shock group). Calculate each patient's APACHE Ⅱ score and the incidence rates and fatalits of groups.Results: The fatalits and MODS incidence rates of sepsis systemic infection SIRS group and septic shock SIRS group were higher than that of the unsepsis SIRS group. The difference was significant(P <0.05). The incidence rate of SIRS group was higher than that of the non-SIRS group,the difference was significant(P <0.01). The fatalits was higer than 50% if the MODS happened. The higher the APACHE Ⅱ scores were, the higher fatalits would be. The highest fatalies lies in the multiple trauma patients with the severe brain injury.Conclusion: From multiple trauma to SIRS and MODS is one of the clinical common processes advanced gradually. To discover SIRS and adjust inflammatory secondary effectively and prevent the evelopments in early stage is probably the key of reducing the MODS incidence rates and improving the prognosis of the multiple trauma patients especially the severe ones.
出处
《温州医学院学报》
CAS
2002年第1期31-33,共3页
Journal of Wenzhou Medical College
