肺心病急发期并发多脏器功能损害与预后因素探讨

STUDY ON MSOF COMPLICATED IN THE ACUTE PHASE OF PULMO-NARY HEART DISEASE AND ON PROGNOSIS FACTORS

我院1985年1月至1989年10月收治的378例次肺心病急发期合并多脏器功能损害(Msof)156例41.2％,死亡53例(34.0％)。其中单脏器损害最多是肺脑91例(58.3％),病死率最高是DIC,5例均死亡,其次是上消化道出血死亡21例(72.4％)、循环衰竭死亡11例(57.8％)。本文提示:肺部感染、严重低氧血症、CO_2潴留为发病基础,同时,对并发MSOF的发病机理,影响预后的因素进行了讨论,井提出了降低病死率的几个关键性问题。

This article reports a clinical study on 378 cases of pulmonary heart disease(PHD) from January 1985 to October 1989,MSOF was found in 156 cases(41.6%),among them 53 cases resulted death (34.3%).In the survivors pulmonary encephalopathy (PE) occurred mostly to cases with single organ damage. DIG caused the highest mortality ( 100% ) ,below it were the hemorrhage of upper digestive tract and the circulatory failure. It was noted that pulmonary jnfec tion, serious hypoxemia, retention of carbon dioxide and acidosis 'were basic causes of PE. The article also discussed the mechanism of MSOF complicated in the acute phase of PHD and the factors affecting the prognosis of it.Several key problems of reducing mortality of it were put forward too.