恶性梗阻性黄疸全身炎症反应综合征152例临床分析

A clinical study on systemic inflammatory response syndrome and multiple organ dysfunction syndrome in 152 patients with malignant obstructive jaundice.

目的 提高恶性梗阻性黄疸病人全身炎症反应综合征 (SIRS)与多器官功能障碍综合征 (MODS)关系的认识 ,探讨MODS的防治策略。方法 分析 15 2例恶性梗阻性黄疸病人SIRS的临床资料 ,病人至少符合 2项SIRS诊断标准 ,包括发热、体温过低、心动过速、呼吸急促或白细胞计数异常。结果 术前出现SIRS者 5 8例 ,发生率 3 8 1% ,其后MODS发生率 3 6 2 % ,病死率为 13 8%。MODS中胃肠功能衰竭最常见 ,随着SIRS标准项目的增加 ,MODS的比例也增加 ,但差异不显著 (P >0 0 5 )。结论 早期诊断SIRS ,积极调控机体炎症反应 ,是改善恶性梗阻性黄疸病人预后的关键。

Objective To analyze the relation between systemic inflammatory response syndrome(SIRS)and multiple organ dysfunction syndrome(MODS)and probe the therapeutic strategies.Methods The clinical data of 152 patients accepted by our hospital from January 1995 to December 1999 were analyzed.The patients met at least two of the criteria for SIRS such as fever,hypothermia,tachycardia or abnomal white blood cell count.Results 58(38\^1%) of the 152 patients investigated met two or more of the criteria for SIRS.The mobidity of SIRS was 38\^1%,afterwards the morbidity of MODS was 36\^2% and the mortality of the patients with SIRS was 13\^8%.The most common syndrome was gastrointestinal organ dysfunction.The proportion of patients suffering from MODS increased with the number of SIRS criteria that the patients met,but there was no statistical significance(P>0\^05).Conclusion The outcome of the patients with malignant obstructive jaundice can be improved on condition that SIRS is early diagnosed and the body inflammatory response is properly regulated.