蝴蝶效应与临床思维——一例多器官衰竭患者诊疗反思

Butterfly Effect and Clinical Thinking:Reflections on the Diagnosis and Treatment of A Patient with Multi-organ Failure

多器官衰竭或多器官功能障碍综合征在临床中尤其是急诊及重症监护室内常见,各种病因所致的疾病进展到一定程度均可导致多器官衰竭。在本案例中,一例老年男性患者,以急性腹泻起病,后短时间内进展为多器官衰竭。通过对该例患者病史总结、病理生理机制的探讨,以及对整个诊疗过程的反思,结合“蝴蝶效应”理论,总结出一种新的临床思维,并探讨“蝴蝶效应”理论在对该例患者的诊断、治疗甚至医患沟通方面所起到的作用,以期通过参考该案例,对以后的临床工作起到一定帮助。

Multiple organ failure or multiple organ dysfunction syndrome(MODS),always caused by various causes,are common in clinic,especially in emergency department and intensive care unit(ICU).In this case study,an old man started with acute diarrhea and progressed to multiple organ failure within a short time.Through the summary of his medical history and pathophysiologic mechanism,the authors reviewed the whole process of his diagnosis and treatment.Based on the"butterfly effect"theory,this paper summarized a new clinical thinking,and explored the impact of the"butterfly effect"theory on the patient's diagnosis and treatment and the doctor-patient communication of this case,so as to provide reference for the future clinical practice.