体外循环术后多器官功能不全的治疗经验  

Management of postoperative multiple organ dysfunction syndrome after cardiopulmonary bypass

作　　者：谭文锋[1] 杨康[1] 廖克龙[1] 曾会昌[1] 王明荣[1] 

机构地区：[1]第三军医大学西南医院胸心外科,重庆400038

出　　处：《第三军医大学学报》2005年第24期2455-2457,共3页Journal of Third Military Medical University

摘　　要：目的报告22例体外循环术后多器官功能不全(multipleorgandysfunctionsyndrome,MODS)的治疗经验。方法1998年1月至2005年9月,共治疗22例体外循环术后多器官功能不全患者,其中二尖瓣置换术后5例,主动脉瓣置换术后3例,二尖瓣及主动脉瓣置换术后10例,室缺修补术后2例。胸主动脉人工血管置换术后2例。术前心功能I级1例,Ⅱ级6例,Ⅲ～Ⅳ级15例。均于术后第2～12天出现MODS,出现功能不全的器官包括心、肺、肾、肝、脑、胃肠道以及凝血系统。结果救治存活15例,7例死亡,病死率31.82%,救治成功与否与手术类别无明显关系。结论多器官功能不全治疗困难,应以预防为主。早期发现,早期支持治疗可降低病死率。Objective To report the experience on treating postoperative multiple organ dysfunction syndrome （MODS） after cardiopulmonary bypass （CPB） in 22 cases. Methods In 22 patients, MVR had been performed in 5 cases, AVR in 3 and DVR in 10, repair of ventricular septal defect （RVSD） in 2 and replacement of thoracic aorta with artificial vessel （RTAAV） in 2. Before operation, NYHA functional class Ⅰ was in 1 patient, Ⅱ in 6, and Ⅲ-Ⅴin 15. MODS in 22 patients occurred within 2 - 12 d after operation, and organs involved heart, lungs, kidneys, liver, brain, gastrointestinal tract and blood coagulation system. Results Fifteen of the 22 cases survived and 7 died. The mortality was 31.82%. The types of operation （MVR, AVR, DVR, RVSD and RTAAV） showed no correlation with the result of MODS. Conclusion Treating MODS is difficult, and active measures for preventing MODS are valuble. Early recognition and treatment can reduce mortality rate.

关 键 词：体外循环 多器官功能不全(MODS) 治疗 

分 类 号：R422.8[医药卫生—临床医学] R619