影响多器官功能障碍综合征患者病死率的因素分析

Analysis of mortality in the MODS cases

目的 探讨影响多器官功能障碍综合征 (MODS)病死率的因素。方法 分析 12 9例MODS患者不同原发病、脏衰数及单个器官功能不全与病死率的关系。将存活患者与死亡患者的各项指标进行比较。结果 不同原发病、脏衰数及单个器官功能不全的MODS患者的病死率不同 ;存活组与死亡组比较 ,APACHEⅢ评分于第 1天、APACHEⅡ评分于第 2天产生差异。自第 3天起产生显著性差异的指标为MAP、尿量 ;自第 5天起产生差异的指标为WBC ;自第 7天起产生差异的指标为CVP、pH、TBIL、ALB及Cr。Logistic分析显示 ,脏衰数及APACHEⅢ评分对病死率有影响。结论 通过原发病、脏衰数、单个器官功能不全及一般指标的变化趋势可以对MODS患者的预后进行评判。

Objective To investigate the outcome and predictive factors of multiple organ dysfunction syndrome(MODS).Methods We retrospectively studied the relationship of the mortality with original causes of MODS,the numbers of dysfunctional organ,the single dysfunctional organ, and compared the parameters between survival patients and dead patients.Results The mortality were different in original causes of MODS,the numbers of dysfunctional organ,the single dysfunctional organ.There were significant differences in the APACHEⅢ scores from the first day, the APACHEⅡ scores from the second day.The MAP,urine output showed significant differences from the third day,the WBC from the fifth day,and the CVP,pH,TBIL,ALB,Cr from the seventh day.The Logistic analysis indicated the numbers of dysfunctional organ and the APACHE?Ⅲ scores could influence the mortality.Conclusion We can predict the prognosis of MODS patients according to the original causes of MODS,the numbers of dysfunctional organ,the single dysfunctional organ and the tendency of common parameters.