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编号:11024654
抢救失血性休克并发MODS累及6个脏器功能1例报告及文献复习
http://www.100md.com 《中华现代临床医学杂志》 2000年第11期
多器官功能障碍综合征;中西医结合;治疗;休克,出血性,,多器官功能障碍综合征;中西医结合;治疗;休克,出血性,1资料与方法,2讨论
     【摘要】 目的 提高对多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)的认识、预防、诊断、治疗水平。方法 报告成功抢救1例经腹腔镜左肾淋巴管结扎手术后左肾静脉钛夹意外脱落失血性休克,导致心跳呼吸骤停复苏后再手术并发MODS累及6个脏器功能衰竭过程及有关治疗,并复习相关文献,介绍目前关于MODS的研究进展。结果 确诊1例因失血性休克心跳呼吸骤停复苏后并发MODS,累及脑、心、肺、肝、肾、血液、胃肠等6个脏器。经积极采取中西医结合对症、支持救治,各生理指标全部恢复正常,康复出院。结论 MODS的发生机制非常复杂,在严重感染、创伤、缺氧等打击下,失控的过度炎症反应激活多种细胞因子和炎症介质的释放,使MODS发生率升高。尽早去除病因,尽早给予各种生命支持治疗,尽早对可能发生全身炎症反应综合征(SIRS)、MODS识别并给予干预治疗,包括中西医结合治疗能改善MODS的救治成功率。

    【关键词】 多器官功能障碍综合征;中西医结合;治疗;休克,出血性

    Hemorrhagic shock complicated by MODS involving 6 organs:one case report and review of literatures

    WANG Jing-en,CAI Jin-fang,WANG Zhi-hua,et al.

    ICU,Central Hospital,Nanhui District,Shanghai 201300,China

    【Abstract】 Objective To raise the level of regarding congnition,prevention,diagnosis and therapy on multiple organ dysfunction syndrome(MODS).Methods Report the process and correlative therapy on one case who occured with MODS involving 6 organs after hemorrhagic shock lead to heartbeat and respiration stopping suddenly and resuscitated resulting in left nephrostome titanium nip falled off accidentally from left kidney lymphatic fastening.At the same time,The author reviewed correlative literature and introduce the investigative progress about MODS.Results One case who happened with MODS following hemorrhagic shock,heartbeat and respiration stopped suddenly was diagnozed and resuscitaed.6 organ dysfuncted including brain,heart,lung,liver,kidney and the digestive system.After being given therapy integrated Chinese and Western medicines,allopathy and nutritional treatment,all circadian parameters of the case came back in gear and discharged at last.Conclusion The mechanism about MODS is very complicated.Because of serious infection,hurt and oxygen-lack,excessive inflammatery reaction activates multifarious cell factors and inflammatery mediums,which improve the happen-rate of MODS.Wiping off pathogeny,providing life-sustain treatment and recognising SIRS and MODS in time and adopting corresponding therapy,such as treatment integrated Chinese and Western medicines,can improve the hit-rate of cure on MODS. ......

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