慢性肺心病并发多系统器官功能衰竭(附100例临床分析)

Cor Pulmonale complicated by MSO Failure (enclosed herewith 100 clinical analysis)

本文报告我院1984～1991年收治的慢性肺心病212例,其中并发多系统器官功能衰竭(MSOF)100例(47.2％),病死率48％,并发衰竭的器官愈多,病死率愈高;血气分析显示PH值与PaO_2值越低,预后越差,而PaCO_2值越高,预后亦越差。在呼吸衰竭和/或心力衰竭的基础上并发中枢神经系统损害最多(52％),其次为肾、肝等。并分析慢性肺心病易并发MSOF的机理主要是长期低氧血症导致各器官功能相继发生衰竭,而感染是最常见的诱因。强调及时有效地控制感染,纠正缺氧与CO_2潴留,改善心肺功能与微循环,注意电解质和酸碱平衡,纠正低蛋白血症,加强营养与护理,提高患者免疫功能,密切监测各器官功能状态等,对降低其并发率与病死率具有重要作用。

This paper reports 100 cases complicated by MSO Failure out of 212 patients, who suffered from chonic cor pul-monale in our hospital in recent years (amounting to 47.2%). The death rate is 48%. The more failure organs are, the higher death rate is. The blood analysis shows that the lower the PH and PaO_2 are, the worse the result is; and the higher thc PaCO_2 is, the worse the result also is. In the respiration failure and (or) heart failure the case of damaging the centre nervous system ranks first, damaging the kidney, liver and other organs second. The paper goes on to anylyze that cor pul-monable easily complicated by MSOF, which mostly results from infection, is mainly due to long--time hypoxemia caus-ing the relative organ failure. It emphasizes that in order to lower its complication and cut down the death rate it's impor-tant to make an carly diagnosis and take effective measures to control carly infection effectively, to release hypoxemia and the state of high corbon diaxide, to improve the heart and lung function and micro--circutation, to change hypelbu-minemia well, to stimulate immunzation system response. Meanwhile attention chould be paid to the change of electrolyte and the PH. to strengthening nutrient and care, to guarding closely the function of each organ etc.