吸入性损伤后多器官衰竭

Multiple organ failure in burn patients combined with inhalation injury.

为探讨吸入性损伤后多器官衰竭的临床特点及其防治,对1977年1月至1991年8月4834例住院病人中366例吸入性损伤进行了回顾性分析。结果显示,4834例烧伤病人中发生 MOF 115例,发生率为2.38%;其中366例吸入伤76例发生 MOF,发生率达20.77%,占烧伤后 MOF 总数的2/3。吸入伤后 MOF 具有发生早、发生率和死亡率较高,呼吸系统并发症多,肺和心功能衰竭发生率高,重度休克较多,缺氧及酸中毒较严重等特点。认为吸入伤本身和休克是吸入伤后 MOF 的主要发病因素,及早采取有效措施防治吸入伤和休克,减轻或纠正组织器官的缺血和缺氧损害,是防治吸入伤后 MOF 的关键。

To define the clinical features and prevention and treatment of multiple organ failure (MOF)developed in burn patients combined with inhalation injury,a retrospective clinical study on 4834 burn patients admitted into the Institute from Jan,1977 to Aug,1991,in which 366 cases sustained inhalation injury,was performed.It was shown that postburn MOF occurred in 115 cases among the 4834 victims,with an incidence of 2.38%.However,of the 366 cases with inhalation injury 76 were com- plicated with MOF,an incidence as high as 20.77%,approximately occupying two-thirds of the postburn MOF.The incidence and mortality of MOF were higher when there was inhalation injury.It occurred earlier.More respiratory complications,higher incidence of lung and cardiac failure as well as severe shock were observed.Moreover,hypoxemia and acidosis were found to be more severe in MOF patients with inhalation injury than those without.It is suggested that good control of inhalation injury and burn shock,as well as the ischemic-hypoxic damage of visceral tissues might be of great importance for the prevention and treatment of MOF in burn patients combined with inhalation injury.