急性脑卒中并发多器官功能衰竭临床预后分析

Clinical Prognosis of Acute Stroke with Multiple Organ Failure

目的分析急性脑卒中并发多器官功能衰竭(MOF)的临床预后情况。方法回顾性分析350例急性脑卒中患者的临床资料,根据MOF的诊断标准,将其分为MOF组与非MOF组,计算各组总病死率、MOF的发生率和不同衰竭器官数目亚组的病死率以及不同类型脑卒中患者并发MOF的病死率,并比较器官受累顺序。结果 MOF组64例,死亡51例,病死率为79.69%(51/64),非MOF组286例,共死亡12例,病死率为4.19%(12/286),两组间病死率比较差异有统计学意义(χ2=201.92,P<0.01)。MOF发生率为18.29%(64/350),其中2个器官功能衰竭14例,死亡8例(57.14%);3个器官功能衰竭30例,死亡24例(80%);4个器官功能衰竭12例,死亡11例(91.67%);5个器官功能衰竭6例与6个器官功能衰竭2例最终全部死亡(100%)。脑出血与脑梗死患者并发MOF的病死率分别为83.33%(40/48)与57.14%(8/14),两者比较差异有统计学意义(χ2=4.25,P<0.05)。器官受累顺序依次为脑、肺、心、胃、肾、肝。结论急性脑卒中并发MOF预后不良,且衰竭器官数目越多病死率越高。但严密监测、积极救治,可改善预后。

Objective To analyze the acute stroke with multiple organ failure （MOF） of clinical prognosis. Methods Retrospective analysis of 350 cases of clinical data of patients with acute stroke, according to MOF＇s diagnostic criteria,divided into MOF group and non-MOF group,each group of total mortality and the incidence of MOF and the sub-groups mortality with the different number of failing organs,and the different types of stroke patients with multiple organ failure mortality,and compare the sequence of organ involvement. Results MOF group of 64 cases,51 cases of death,mortality rate was 79.69%（51/64）,286 cases of non-MOF group,a total of 12 patients died,mortality rate was 4.19%（12/286）,mortality differences between the two groups statistically significant （X^2= 201.92,P〈0.01）. MOF rate was 18.29%（64/350）,14 cases of the two organ failure and death in 8 cases（57.14%）,three organ failure in 30 cases,24 died （80%）,four organ failure 12 cases,ll died （91.67%）,five organ failure in six cases and six-organ failure in 2 cases the final of all deaths （100%）. Cerebral hemorrhage and cerebral infarction complicated by muhiple organ failure and mortality were 83.33%（40/48） and 57.14%（8/14）,the difference was statistically significant （X^2=4.25,P〈0.05）. Order of organ involvement of brain,lung,heart,stomach kidney,liver. Conclusion MOF in acute stroke patients with poor prognosis and organ failure,the more the number of the higher mortality,but close monitoring,active treatment can improve the prognosis.