全身炎症反应综合征与多器官功能障碍综合征的临床研究

Clinical study of systemic inflammatory response syndrome and multiple organ dysfunction syndrome in critically patients

作者前瞻性调查了２３０例危重病患者，根据危重病患者全身性炎症反应综合征（ＳＩＲＳ）和多器官功能障碍综合征（ＭＯＤＳ）的症状，分析ＳＩＲＳ到ＭＯＤＳ的渐进发展过程，探讨治疗策略。结果显示：患者转入加强医疗病房（ＩＣＵ）时，ＳＩＲＳ患病率７１．３％，病死率１８．９％。２３０例患者中，６５例发生ＭＯＤＳ（２８．３％），死亡３３例（５０．８％）。非感染性ＳＩＲＳ、全身性感染及感染性休克患者的ＭＯＤＳ患病率依次为２２．８％，６１．１％和８５．７％，而病死率依次为１１．４％，３０．６％和５０．０％。作者认为，早期诊断ＳＩＲＳ，并积极调控机体炎症反应，可能是改善危重患者预后的关键。

We defined the epidemiology of systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) in critically ill patients, and evaluated the procession from SIRS to MODS and the therapeutic strategies.230 patients were studied prospectively until discharge or death.On admission,the morbidity rate of SIRS was 71 3%. The mortality rate of the patients with SIRS was 18 9%.MODS was developed in 65 patients (28 3%), and 33 patients dided (50 8%). In SIRS patients with non infectious SIRS, sepsis and septic shock, the morbidity rates of MODS were 22 8%, 61 1% and 85 7%, and the mortality rates were 11 4%, 30 6% and 50 0% respectively. The outcome of critically ill patients may be improved if SIRS is early diagnosed and the body inflammatory response is reglulated properly.