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目的 探讨肺心病急发期并 MOF的发病诱因、发病机制、预后及预防措施。方法 收集我院 1 996～ 2 0 0 0年间诊治的 5 2例慢性肺心病并发MOF病人的临床资料进行分析。结果 所有患者均存在肺部感染和低氧血症 ,其中合并二氧化碳潴留 3 5例 ,痰培养阳性 3 9例 ,其中 G- 杆菌 2 7例 ,2个器官衰竭 1 8例 ,死亡 3例 (1 6.7% ) ,3个器官衰竭 2 0例 ,死亡 8例 (2 7.6% ) ,4个或 4个以上器官衰竭 1 5例 ,全部死亡 ,总死亡率 5 0 %。结论 肺部感染是慢性肺心病并发 MOF的重要危险因素 ;肺和心脏衰竭的发生率最高和发生最早 ,其次为脑、肾、胃等 ;应用氨基甙类抗生素易诱发或加重肾功能衰竭
Objective To investigate the etiological factors, pathogenesis, prognosis and preventive measures of MOF in acute stage of pulmonary heart disease. Methods The clinical data of 52 patients with chronic cor pulmonale complicated with MOF diagnosed and treated in our hospital from 1996 to 2000 were collected for analysis. Results All the patients had pulmonary infection and hypoxemia. Among them, 35 cases were complicated with carbon dioxide retention and 39 cases were sputum culture positive. There were 27 cases of G-bacteria, 18 cases of 2 organ failure and 3 cases of death (1 6.7%), 20 cases of 3 organ failure, 8 cases of death (7.6%), 15 cases of 4 or more organ failure, all died, the total mortality was 50%. Conclusions Pulmonary infection is an important risk factor of MOF associated with chronic pulmonary heart disease. The incidence of pulmonary and heart failure is the highest and the earliest, followed by brain, kidney and stomach. Aminoglycoside antibiotics can induce or aggravate renal failure