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创伤后多器官功能障碍综合征(MODS)是由严重损伤和休克引起的炎症反应失调和器官功能障碍。损伤的肺组织能释放 炎症介质,导致全身器官功能障碍,但肺功能障碍与MODS之间的关系需进一步研究。最近,美国学者对1344例创伤后可能 发生MODS的患者进行了前瞻性研究。纳入标准:年龄>16岁,创伤严重度评分>15分,在创伤重症监护治疗病房(ICU)中 治疗及生存时间超过48 h。排除标准:单纯头部损伤,头部损伤伴有身体其他部位损伤且简易创伤评分<2分。在外科ICU记 录28 d的临床指标和实验室数据,直至患者死亡或出院。按MODS评分标准诊断发现,1344例患者中有1011例(75％)发生 了器官功能衰竭,其中951例(94％)出现肺功能障碍,605例MODS患者中有598例出现肺功能障碍。出现肺功能障碍的时间 比出现心功能障碍的时间平均早(0．6±0．2)d,比肝功能障碍早(4．8±0．2)d,比肾功能障碍早(5．5±0．2)d。研究者认为,肺损 伤的严重程度决定心、肝、肾等器官功能障碍以及发生功能障碍的器官数目,肺功能障碍在促进炎症性损害和MODS的发展 中起重要作用。
Post-traumatic multiple organ dysfunction syndrome (MODS) is a disorder of inflammatory response and organ dysfunction caused by severe injury and shock. Injured lung tissue can release inflammatory mediators, leading to systemic organ dysfunction, but the relationship between pulmonary dysfunction and MODS needs further study. Recently, the United States scholars conducted a prospective study of 1344 patients with traumatic post-traumatic MODS. Inclusion criteria: age> 16 years, and trauma severity score> 15 points. Patients were treated and survived for more than 48 hours in intensive care unit (ICU). Exclusion criteria: Simple head injury, head injury with damage to other parts of the body and easy trauma score <2 points. The 28-day clinical data and laboratory data were recorded in the surgical ICU until the patient died or was discharged. According to the MODS score, 1011 (75%) of 1344 patients developed organ failure, of whom 951 (94%) developed pulmonary dysfunction and 598 of 605 patients with MODS developed pulmonary dysfunction. The onset of pulmonary dysfunction was earlier (0.6 ± 0.2) days earlier than the onset of cardiac dysfunction and earlier (4.8 ± 0.2) days than the dysfunction of the liver, earlier than the renal dysfunction (5. 5 ± 0.2) d. Researchers believe that the severity of lung injury determines the number of organ dysfunction such as heart, liver and kidney and the number of organs with dysfunction, and lung dysfunction plays an important role in promoting inflammatory damage and MODS development.