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目的 提高恶性梗阻性黄疸病人发生全身炎症反应综合征 (SIRS)与多器官功能障碍综合征 (MODS)的认识 ,探讨其发生机制及防治策略。方法 回顾近 5年手术治疗的 93例恶性梗阻性黄疸病人的临床资料 ,按照SIRS和MODS的诊断标准进行分析研究。结果 术前出现SIRS者 32例 (34 4 % ) ,SIRS者术后易发生MODS(P <0 .0 1) ,MODS中以胃肠道功能衰竭最为常见 (18 7% )。结论 SIRS至MODS是一个连续过程 ,其本质是SIRS ,改善恶性梗阻性黄疸预后关键在于早期认识SIRS ,预防胆道感染 ,降低胆红素水平 ,减少内毒素血症
Objective To improve the understanding of systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) in patients with malignant obstructive jaundice and to explore its mechanism and prevention and treatment strategies. Methods The clinical data of 93 patients with malignant obstructive jaundice who underwent surgical treatment in the recent 5 years were retrospectively analyzed and analyzed according to the diagnostic criteria of SIRS and MODS. Results 32 (34.4%) patients had SIRS preoperatively, and MODS occurred more frequently in SIRS patients (P <0.01). Gastrointestinal failure was most common in MODS patients (18.7%). Conclusion SIRS to MODS is a continuous process, the essence of which is SIRS. The key to improve the prognosis of malignant obstructive jaundice lies in early recognition of SIRS, prevention of biliary tract infection, lowering of bilirubin level and reduction of endotoxemia