重症肝炎并发多器官功能衰竭175例

Severe hepatitis complicated multiple organ dysfunction

目的探讨重症肝炎并多器官功能衰竭的临床特征．方法对１７５例重症肝炎并多器官功能不全的诱因、发病机制、病死率及预后进行分析．结果急性、亚急性和慢性重症肝炎并发多器官功能不全的病死率分别为８５７％，８１８％和７１８％，最常见的诱因为感染、消化道大出血及电解质紊乱，预后与重症肝炎类型、受损器官数目、年龄、并发症的器官与系统、妊娠及重叠感染密切相关．结论重症肝炎并发多器官功能不全的发病机制复杂，其中微循环障碍可能是中心环节．

AIM To explore the clinical features in severe hepatitis with multiple organ dysfunction. METHODS One hundred and seventy five patients with severe hepatitis with multiple organ dysfunction were analysed for their risk factors, pathogenesis, mortality and prognosis. RESULTS The mortality of acute, subacute and chronic severe hepatitis with multiple organ dysfunction was 85 7%, 81 8% and 71 8% respectively. The most common risk factors were infection, severe gastrointestinal bleeding and electrolyte disorder. The prognosis was closely related with the type of severe hepatitis, number of damaged organs, age, complicated organ and system, pregnancy and coinfection. CONCLUSION In the pathogenesis of severe hepatitis with multiple orgon dysfunction, the microcirculation disorder is the key fator, the mortality is positively correlated to the number of damaged organs.