创伤后多器官功能障碍综合征临床诊疗专家共识  

Chinese expert consensus on diagnosis and treatment of traumatic multiple organ dysfunction syndrome

作　　者：中国研究型医院学会休克与脓毒症专业委员会 中国人民解放军战创伤学专业委员会 姚咏明[2] 解立新 周飞虎 祝筱梅[2] 肖坤 毛智 Shock and Sepsis Society of the Chinese Research Hospital Association;War Wound and Trauma Society of the Chinese People's Liberation Army(PLA)

机构地区：[1]不详 [2]中国人民解放军总医院医学创新研究部、第四医学中心 [3]中国人民解放军总医院第八医学中心 [4]中国人民解放军总医院第一医学中心

出　　处：《中华危重病急救医学》2022年第3期225-238,共14页Chinese Critical Care Medicine

基　　金：国家自然科学基金重点及面上项目(82130062, 81730057, 81871557);军事医学创新工程重点项目(18CXZ026, BLJ18J006)

摘　　要：多器官功能障碍综合征(MODS)是造成创伤患者后期高病死率的主要原因。过度的炎症反应、免疫功能障碍、凝血纤溶异常以及多器官系统相互作用的网络效应参与了严重创伤后MODS的病理生理过程。早期预警、准确诊断、及时恰当的器官支持和辅助治疗有助于改善创伤后MODS患者的不良预后。组织全国专家学者通过文献检索、分析和评价,综合相关循证医学及临床试验证据,并结合专家经验,着重从创伤后MODS的病理生理机制、预警、诊断、治疗、康复措施等方面编写本专家共识,旨在帮助临床医生加深对创伤致MODS的认知和规范临床救治工作。Multiple organ dysfunction syndrome(MODS)is the main cause of high mortality in late stage of patients following major trauma.On the basis of literature retrieval and analysis,combined with evidence-based medicine and clinical trial reports together with expert experiences in clinical practice,we compiled this expert consensus,which focused on the pathophysiological mechanism,early prediction,diagnosis,treatment,and rehabilitation of traumatic MODS,in order to help clinicians understand the basic pathogenesis and standardize the clinical management.The pathogenic mechanisms of MODS after severe trauma mainly include excessive inflammatory response,immune dissonance,abnormal coagulation,and the dysregulated networks among multiple organs as well as systems.Early and accurate diagnosis,timely and appropriate organ support,and adjuvant therapy might effectively improve the poor outcomes of patients with traumatic MODS.

关 键 词：创伤 多器官功能障碍综合征 诊断 器官支持治疗 康复 

分 类 号：R641[医药卫生—外科学]