腹部外科急症患者全身性炎症反应综合征和多器官功能不全综合征的临床研究

A Clinical Study on Systemic Inflammatory Response Syndrome and Multiple Organ Dysfunction Syndrome in Patients with Abdominal Surgical Emergency

为了解全身性炎症反应综合征（ＳＩＲＳ）向多器官功能不全综合征（ＭＯＤＳ）的发展过程，探索ＭＯＤＳ的防治策略，作者回顾性研究了１３７４例腹部外科急症患者的临床资料。结果显示：腹部外科急症患者入院时ＳＩＲＳ的发生率是３５．２％，其后ＭＯＤＳ发生率是６．４％，病死率是４．８％。经治疗（包括手术和保守治疗）４８小时后，仍伴有ＳＩＲＳ的病例中，约三分之一的患者（３３／１００）发展为ＭＯＤＳ。该１３７４例患者中，４０例发生ＭＯＤＳ（２．９％），死亡２７例（６７．５％）。作者认为，早期诊断ＳＩＲＳ，特别是注意分析治疗４８小时后仍伴有ＳＩＲＳ患者的原因，积极调控机体炎症反应，是改善腹部外科急症患者预后的关键。

In order to analyze the development from systemic inflammatory response syndrome(SIRS) to multiple organ dysfunction syndrome (MODS) and probe the therapeutic strategies,the authors studied retrospectively the clinical data of SIRS and MODS in 1374 patients with abdominal surgical emergency. The results showed that on admission the morbidity of SIRS was 32.5%, afterwards the morbidity of MODS was 64%, and the mortality of the patients with SIRS was 4.8%. After 48 hours therapy, MODS developed in 330% of the SIRS cases. Of all the 1374 patients, 40 developed MODS(2.9%) and 27 died (67.5%).The authors point out that the outcome of the patients with abdominal surgical emergency can be improved on condition that SIRS is eaAuthor rly diagnosed, the cause of SIRS after 48 hours of therapy is well difined, and the body inflammatory response is properly regulated.