MODS患者脱证的诊断探讨

The Diagnostic Study of Collapse Syndrome in Patients with MODS

目的研究多脏器功能不全(MODS)患者脱证及其诊断。方法选取109例MODS患者按照中医诊断学辨证标准进行中医辨证,按照某一证型的有无将患者分为无此证型组和有此证型组,筛选出两组之间有显著差异的指标,对其指标进一步分析以筛选出最能反映证型变化的指标。结果在脱证和非脱证之间差异有显著的指标,按照对判别脱证有无的作用大小依次排列为:末梢冷、声音微弱无力、舒张压降低、冷汗不止、收缩压降低、神情烦躁或淡漠、皮肤瘀点瘀斑、面色苍白、脉微欲绝、MAP降低、舌苍白、舌瘀点、PT延长、心率增快、BUN升高、尿量减少、口干欲饮、APTT延长等。结论脱证与末梢循环障碍表现一致,可用血压降低等诊断。中医证型诊断和西医诊断可相互补充,有助于更合理地指导相应中医药的临床应用。

Objective： To study Collapse Syndrome and the diagnosis of MODS. Methods： 109 patients with MODS were differentiated on the standard of diagnosis of TCM and divided into two groups which with or without a system based on some Syndrome, In the two groups, the items with obvious differentia should be vepreseutative after they were seleeted. Results： The items of obvious differentia in the tow groups which with or without Collapse Syn- drome were vanged by their effec,~ cold peripheral, faint sound, lower DBP, cold sweat, lower SBP, fidpet or dimface, petechia, pallor face, faint pulse, et al. Conclusion： Collapse Syndrome accorded with dusturbance of peripheral ciraulation and was vepresented with lower BP.