心脏术后多器官功能障碍综合征的防治

The prevention and management of multiple organ dysfunction syndrome following cardiac surgery

目的 总结 3 0例心脏术后多器官功能障碍综合征 (MODS)病人的防治体会。方法 对 30例MODS病人的临床资料进行了分析 ,并对MODS的预防进行了探讨。结果 2 1例心肺功能衰竭病人 ,死亡 1例 ;5例 3个系统衰竭病人 ,死亡 4例 ;4例 3个以上系统衰竭病人 ,全部死亡。总死亡例数占心脏病人总数的 0 .9% ,占MODS的 33 .3 %。结论 提高手术技巧、缩短主动脉阻断时间、正确处理低心排、细致的呼吸系统管理、预防感染。

Objective: To review the experience of treatment and prevention for multiple organ dysfunction syndromes (MODS) following cardiac surgery. Method: Clinical data of 30 cases of MODS were reviewed during the period of 1990-1998. Results: Among 21 cases of heart and lung failure, one patient died. 5 cases had three organ failure and 4 died. 4 cases had more than three organs failure, and all died. The mortality rat was 0.9% in all cardiac surgery patients and 33.3% in those with MODS. Conclusions: Improved operative technique, reduced aortic cross clamp time, proper treatment of low cardiac output syndrome, careful management of respiratory disorder, prevention infection and sufficient quantity of caloric supply are important factors.