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目的 调查 1 998年 5月～ 2 0 0 3年 5月北京地区多器官功能障碍综合征 (MODS)的临床诊治现状。 方法 回顾性调查分析北京地区 4 1 3例MODS患者的临床资料。 结果 MODS原发病因仍然是重症感染、创伤、重症胰腺炎、大手术后。 4 1 3例MODS患者 ,总的住院病死率为 5 3.5 %(2 2 1 41 3) ,住院 2 8d内病死率为 37.3%(1 5 4 41 3)。发生功能障碍器官的数为 2～ 6个 ,相对应的MODS病死率为 4 2 .5 %～ 1 0 0 %。住院第 1周内并发脑、心、肾、呼吸功能障碍者病死率分别为 72 .8%、6 4 .3%、6 1 .7%、5 4 .8%。治疗中呼吸机使用频率为 76 .0 %,而透析的应用频率为8.2 %。结论 MODS总的病死率依然较高。重症感染、创伤、重症胰腺炎、大手术后是MODS的主要原发病因。MODS病死率随着发生功能障碍器官的数增加而显著升高。
Objective To investigate the clinical diagnosis and treatment of multiple organ dysfunction syndrome (MODS) in Beijing from May 1998 to May 2003. Methods The clinical data of 413 MODS patients in Beijing area were retrospectively analyzed. Results The primary cause of MODS was still severe infection, trauma, severe pancreatitis and major surgery. Among 413 patients with MODS, the overall in-hospital mortality was 53.5% (2 2 1 41 3), and the hospital mortality rate was 37.3% (1541 41) within 28 days. The number of dysfunctional organs was 2 to 6, and the corresponding MODS mortality was 42.5% -100%. In the first week of hospitalization, the case fatality rates of brain, heart, kidney and respiratory dysfunction were 72.8%, 64.3%, 61.7%, 54.4% respectively. Treatment of ventilator frequency of 76.0%, while the application of dialysis frequency of 8.2%. Conclusion The overall mortality of MODS is still high. Severe infection, trauma, severe pancreatitis, major surgery is the main primary cause of MODS. MODS mortality increased significantly with the number of dysfunctioned organs.