摘要
我们对36例严重烧伤后多脏器功能衰竭的病例进行了回顾性分析,对严重烧伤后多脏器功能衰竭的诱发因素和发生规律进行了探讨.除伤情严重程度外,吸入性损伤、休克和败血症是多脏器功能衰竭的主要诱发因素。由于目前临床无特殊治疗方法,故应特别注重多脏器功能衰竭的预防。
36 cases with multiple organ failure(MOF)in a group of 178 severe burn injury patients during 1969～1989 were observed in our department.The rate of occurrence of MOF in this group was 20.2%(36/178).25 cases out of these 36 patients died,and the mortality rate was 69.5%(25/36).In 10 cases 2 organs were involved,and two patients died,3 organs were involved in 13 cases and nine of them died;more than 4 organs were affected in 13 cases and all of them died.The elatigaship between MOF and shock,inhalation injury as well as septicemia was discussed.Although there were many factors which could induce postburn multiple organ failure(PBMOF),the severity of the injury was the most fundamental induc- ing factor.The severer the burn injury,the higher the morbidity and mortality of PBMOF. Both shock and inhalation injury were important inducing factors in early PBMOF.Wound sepsis and septicemia were major inducing factors in delayed PBMOF.Majority of the delay- ed PBMOF took place during septicemia. In consideration of the high mortality of PBMOF and lack of effective treatment at pre- sent,it is extremely important to prevent severe burn injury patients from developing PBM- OF.The measures to prevent PBMOF included:to correct shock adequately as soon as posis- ble,to select the optimal time and appropriate extent of escharectomy and skin grafting,to try our best to ensure complete or near complete take of skin grafts,and to strengthen sys- temic metabolic support.
