急性脑梗死并发老年多器官功能不全综合征临床特点分析

Clinical features of acute cerebral infarction complicated with multiple organ dysfunction syndrome in the elderly

目的探讨高龄急性脑梗死并发老年多器官功能不全综合征(MODSE)的发生率、发病机制、防治与预后。方法回顾性分析152例高龄患者急性脑梗死的临床资料,并发MODSE的为MODSE组36例,无MODSE为对照组116例,将两组进行对比分析。结果152例高龄急性脑梗死患者并发MODSE 36例,发生率为27.08%。MODSE组病死率45.35%,无MODSE组病死率4.35%,两组病死率差异具有统计学显著性。容易受累的脏器依次为肺脏、心血管系统、脑、肾脏、消化道、肝脏;随着所累及器官越多,病死率越高,梗死面积越大,MODSE发病率越高。死亡的主要原因系继发呼吸衰竭、心力衰竭、心跳骤停、脑损害及脑疝、肾功能衰竭。结论高龄急性脑梗死患者并发MODSE发生率高,病死率高。继发呼吸衰竭、心力衰竭、心跳骤停、脑损害及脑疝、肾功能衰竭是死亡的主要原因。

Objective To discuss the incidence, pathogenesis, prevention and prognosis of with acute cerebral infarction （ACI） patients complicated with multiple organ dysfunction syndrome in the elderly （MODSE）. Methods A retrospective review of the clinical data of 152 elderly patients with ACI was conducted; 36 patients with MODSE were defined as MODSE group, 116 patients without MODSE were defined as control group. We comparatively analyzed the data of the two groups. Results In the 152 elderly patients with ACI, there were 36 cases complicated by MODSE, the incidence rate was 27.08%. The mortality of MODSE group was 45.35%;and the motality in control group was 4.35%; there was a significant difference of mortality between the two groups（P〈0.01）. We found that the organ easily affected were the lungs, cardiovascular system, brain, kidneys, gastrointestinal tract, liver successively. The more the organ involved,the higher the morality and the larger the infected area was. The main reasons of death was secondary respiratory failure, cardiac failure, cardiac arrest, cerebral lesion and cerebral hernia and kidney failure. Conclusion The incidence rate of elderly patients with ACI complicated by MODSE is higher with higher mortality. The main reasons lead to death are secondary respiratory failure, cardiac failure, cardiac arrest, cerebral lesion and cerebral hernia, and kidney failure .