老年肺心病并发多器官功能不全综合征71例临床分析

Clinical analysis of pulmonary heart disease and multiple organ dysfunction syndrome in the elderly

目的探讨老年多器官功能不全综合征(MODSE)与电解质、血气分析及病死率的关系。方法分析71例老年肺心病合并MODSE的临床资料,将其分成衰竭前期组与衰竭期组,对其肺、心、肾、脑、肝等多器官功能进行评价,对其电解质、血气分析进行统计,并分析诱因构成。结果感染是MODSE的主要诱因,衰竭期组低钠血症、呼吸性酸中毒合并代谢性酸中毒、呼吸性酸中毒合并代谢性碱中毒的发生率以及2个器官功能不全病死率显著高于衰竭前期组;MODSE病死率随器官功能不全数目增多而增加。结论重视MODSE的早期预警和干预,重视MODSE的肺启动作用,可防止MODSE的发生;重视MODSE衰竭前期救治,减少功能不全器官数,才能降低病死率、改善预后。

Objective To evaluate the relationship between multiple Organ dysfunction syndrome in the elderly （MODSE） and electrolyte, blood gas measurement and mortality. Methods The clinical data of 71 elderly patients with pulmonary, heart disease and MODSE were studied. The function of lung, heart, kidney, digestive organs, brain and liver was evaluated, the results of electrolyte and blood gas measurement were studied, and inducements were analyzed. Results Infection was the main inducement of MODSE. The incidences of hyponatremia, respiratory acidosis and metabolic acidosis, respiratory acidosis and metabolic alkalosis and the mortality of two organs dysfunction in the group of prophase failure were higher than those in the group of failure remarkably. With increased dysfunctional organs, the mortality of MODSE increased. Conclusions Attaching importance to the early detection, early therapy and the start-up function of lung can prevent the occurrence of MODSE. Attaching importance to the therapy in the prophase failure of MODSE to reduce the number of dysfunctional organ can reduce the mortality and improve the outcome.