全身炎症反应综合征致多脏器功能衰竭临床分析及防治

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全身炎症反应综合征(SIRS)作为一种新的综合征概念在1991年美国芝加哥危重症学会召开的联合会议上被明确定义。SIRS可无明确感染源,但创伤感染触发SIRS与多脏器功能衰蝎(MOF)间存在相关性和影响,其发生机理至今尚未明了。本文旨在通过临床病历分析来探讨二者相关性及防治,为此选择了98例创伤感染符合SIRS标准合并MOF的患者,分成创伤和感染组进行临床分析,二组血压、血氧、血BUN数差平均值的统计学检验差异无显著意义,而血白细胞计被创伤组,感染组15.00±6.8前者高于后者,t检验有显著意义,从而验证SIRS不完全由感染引起。为此结合文献探讨了中性粒细胞在MOF中的作用及炎性介质反应的机理。本组资料显示MOF累及最多的是呼吸循环系统,病死率最高为肾衰和代谢衰竭,分别为73.33%和75.60%,而且原发病不同,首发受累器官不同。本文就ARPS,感染、胃肠外营养患者根据不同治疗措施分为治疗组和对照组进行分析,其两组生存率有明显差异。基于此,参考文献对降低MOF发病享和死亡率提出防治措施:①抑制炎症反应刺激物,阻断炎性反应介质。②早期纠正并维持水电平衡;③全面营养支持疗法;④多措施综合防治。 The concept of systemic inflammatory response syndrome (SIRS) as a new syndrome was clearly defined at a 1991 joint meeting of the American Society of Critical Care Medicine in Chicago. SIRS may not have a clear source of infection, but there is a correlation and impact between SIRS and multiple organ function test (MOF) caused by wound infection. The pathogenesis of SIRS is still unknown. This paper aims to explore the correlation between the two by clinical analysis of the disease and prevention and control, for the selection of 98 cases of traumatic infection in line with SIRS standard MOF patients were divided into trauma and infection group for clinical analysis, blood pressure, blood oxygen, blood BUN There was no significant difference in the statistical test of the mean difference between the two groups. However, the white blood cell count was significantly higher in the trauma group than in the infected group (15.00 ± 6.8), and the t test was significant in order to verify that the SIRS was not completely caused by the infection . In this connection, we discuss the role of neutrophils in MOF and the mechanism of inflammatory mediators. This group of data show that the most affected MOF respiratory system, the highest case fatality rate of renal failure and metabolic failure, respectively, 73.33% and 75.60%, and the primary disease is different, the first affected organs are different. In this paper, ARPS, infection, parenteral nutrition patients according to different treatment measures were divided into treatment group and control group analysis, the survival rate of the two groups were significantly different. Based on this, references to reduce MOF morbidity and mortality proposed prevention and treatment measures: ① inhibition of inflammatory response stimuli, blocking the inflammatory response medium. ② early rectification and maintenance of hydropower balance; ③ comprehensive nutritional support therapy; ④ multi-measures comprehensive prevention and treatment.
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