26例创伤性多器官功能衰竭的治疗分析  

Treatment of 26 cases of multiple organ failure caused by trauma

作　　者：方国恩[1] 华积德[1] 闻兆章[1] 沈炎明[1] 程远峰[1] 薛绪潮 毕建威[1] 马立业[1] 

机构地区：[1]第二军医大学附属长海医院普外科,上海200433

出　　处：《中华创伤杂志》2000年第10期616-618,共3页Chinese Journal of Trauma

摘　　要：目的　探讨创伤性多器官功能衰竭 (MOF)的治疗。　方法　回顾分析 2 6例多发伤引起的MOF患者各器官衰竭的发生率、衰竭器官数量、治疗方法及血浆肿瘤坏死因子 (TNF)水平的变化与MOF死亡率的关系。　结果　 2 6例MOF患者器官衰竭发生率以肺、心血管系统及肾最高 ,肝、消化道及中枢神经系统最低 ;2个器官衰竭死亡率为 2 5 .0 % ,3个为 36 .4% ,≥ 4个为 5 7.1%。血浆TNF在死亡病例保持较高水平 ,生存病例血浆TNF逐渐降低。大剂量地塞米松、6 5 4- 2联合应用可提高生存率。　结论　 (1)创伤性MOF患者 ,衰竭器官的数量越多 ,死亡率越高。 (2 )血浆TNF水平升高与MOF的发生及死亡有关 ;(3)在积极保护和支持各主要器官功能基础上 ,联合大剂量应用地塞米松、6 5 4- 2 ,对防治MOF有重要作用。Objective To investigate the treatment of multiple organ failure (MOF). Methods The clinical data of 26 cases of MOF caused by multiple injuries were reviewed. The relationship between the number of failure organs, the treatment methods, the level of tumor necrosis factor (TNF) and the mortality of MOF were analyzed, too. Results The morbidities of pulmonary, cardiac, renal, hepatic, gastrointestinal and central nervous systemic failure were 53.8%, 30.8%, 19.2%, 15.4%, 11.5% and 7.7%, respectively. The mortalities of combined 2, 3 and 4 failure organs were 25.0%, 36.4% and 57.1%,respectively. The level of the plasma TNF remained higher in the died, while decreased gradually in the survival. Dexamathasone and anisodamine could increase the survival rate. Conclusions The mortality of MOF increases with the number of failure organs. The morbidity and mortality of MOF are associated with the level of plasma TNF. And dexamathasone and anisodamine combined with other supporting therapy can increase the survival rate of MOF.

关 键 词：创伤性多器官功能衰竭 治疗 肿瘤坏死因子 

分 类 号：R641[医药卫生—外科学]