摘要
目的：调查危重病患者多器官功能衰竭（MOF）的患病率及患病危险因素。方法：回顾性调查1991至1996年1056例危重病患者，利用队列研究方法对MOF的患病危险因素进行分析。结果：1056例危重病患者中，339例发生MOF，患病率32．1％。1991－1996年6年期间MOF患病率无明显变化，以APACHEⅡ评分（＞20分）对患病率进行调整，调整率6年间均无显著变化。对13个因素进行单因素分析，结果免疫功能低下、慢性器官功能衰竭、转入时的高APACHEⅡ评分、创伤或全身性感染等MOF病因、感染部位、大量输血、非手术、低温、SIRS程度等因素与MOF患病的关系显著（P＜0．05）。从器官功能衰竭的分布来看，MOF患者以呼吸衰竭和循环衰竭发生率最高，分别为81．7％（277／339）和81．4％（276／339）。非MOF组717例患者中，201例发生单一器官功能衰竭，其中以呼吸衰竭发生率最高（30．4％），其次为胃肠功能衰竭24．9％（50／201）。结论：90年代以来MOF患病率依然很高，充分认识MOF患病的危险因素，特别是高APACHEⅡ评分、SIRS和低温等重要危险因素，并积极采取有效干预手段，有可能早期预防MOF的发生。
Objective: To study the morbidity of multiple organ failure (MOF) and risk factors in critically ill patients. Methods: We retrospectively studied 1056 critically ill petients from 1991 to 1996. Univariate analysis was performed to idenlify risk factors associated with MOF. Results: MOF occurred in 1056 critically ill petients from 1991 to 1996. The overall morbidity of MOF was 32. 1%, the morbidity adjusted byacule physiology and chronic health evaluation APACHE Ⅱ score showed no significant changes duriny the 6.years. Univariate analysis identified the following risk factors: immunocompromise, chronic organ failure,APACHE Ⅱ seore (> 20), trauma or sepsis, location of infection, massive blood transfusion, nonoperalion, hypothemia and degree of systemic inflammatory response syndrome (SIRS). In patients with MOF,respiratory failure (81 .7% ) and cireulatory failure (81 .4% ) were the most common. In 717 patients withnon - MOF, one organ failure oceurred in 201 patients, respiratory failure was the most common (30.4% ),and gut failure (24.9% ) was the second. Conclusion: The morbidity of MOF showed no trend to declinesince 1990. Prevention of risk factors such as SIRS and hypothermia, may play a key role in the reduction ofMOF mobidity in critically ill patients.
出处
《急诊医学》
CSCD
1999年第1期8-11,共4页
