老年急腹症患者全身炎症反应综合征和多器官功能不全综合征的临床分析  

A clinical study on systemic inflammatory response syndrome and multiple organ dysfunction syndrome in elderly patients with acute abdomen

作　　者：文天夫[1] 李缨来[1] 汤英[1] 苟小清[1] 严律南[1] 

机构地区：[1]华西医科大学附属第一医院外科,成都市610041

出　　处：《中华老年医学杂志》2000年第1期23-25,共3页Chinese Journal of Geriatrics

摘　　要：目的　分析全身性炎症反应综合征 ( SIRS)向多脏器功能不全综合征 ( MODS)的发展过程 ,探索 MODS的防治策略。　方法　回顾性分析 2 80例老年急腹症患者的 SIRS和 MODS的临床资料。　结果　老年急腹症患者入院时 ,SIRS的发生率 4 1 .4 % ,其后 MODS发生率 1 2 .9% ,病死率1 0 .3 % ;经治疗 (包括手术和保守治疗 ) 4 8小时后 ,仍伴有 SIRS的患者 3 9例中 ,1 5例发展为 MODS。2 80例老年急腹症患者中 ,发生 MODS共 1 7例 ( 6.1 % ) ,死亡 1 4例 ( 82 .3 % )。　结论　早期诊断SIRS,特别注意分析治疗 4 8h后仍伴有 SIRS的患者的原因 ,积极调控机体炎症反应 ,是改善老年急腹症患者预后的关键。Objective To analyse the development from systemic inflammatory response syndrome (SIRS) to multiple organ dysfunction syndrome (MODS) and probe the therapeutic strategies for MODS in elderly patients. Methods The clinical data of SIRS and MODS in 280 elderly patients with acute abdomen were retrospectively studied. Results On admission, the morbidity rate of SIRS was 41 4% and MODS 12 9% successively.The mortality rate of the elderly patients with SIRS was 10 3%. After 48 hours of therapy, MODS developed in 15(38 5%) of the 39 cases remaining to have SIRS. Of all the 280 elderly patients, 17 cases (6 1%) developed MODS and 14 (82 3%) patients died. Conclusions The outcome of the patients with acute abdomen may be improved if SIRS is diagnosed earlier, especially the cause of SIRS still remaining after 48 hours therapy. Active control of the inflammatory response is the key to improve the prognosis of acute abdomen in elderly.

关 键 词：急腹症 全身类症反应 综合征 多器官功能衰竭 

分 类 号：R592[医药卫生—老年医学]