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目的探讨高血糖高渗状态(HHS)患者发生多器官功能障碍综合征(MODS)的诱因及影响预后的因素。方法回顾性分析36例HHS患者的临床资料及治疗结果。结果在HHS患者中年龄越大、血钠和血清渗透压越高、既往所患的慢性疾病数目越多,则更容易发生MODS;感染是引起MODS的主要诱因,尤以肺部为最多(43.42%),其次为治疗不当(26%)和脑梗死(13%);36例HHS中死亡12例(33.3%),均为MODS组,病死率为42.9%。发生3个器官功能障碍的病死率为23.3%,4个器官功能障碍为55.6%,5个以上器官功能障碍为100%。结论在HHS患者中,感染是引起MODS的主要诱因,MODS为HHS的重要死因,MODS的病死率与发生功能障碍器官数目有关。
Objective To investigate the causes and prognosis of multiple organ dysfunction syndrome (MODS) in patients with hyperglycemic hypertonic state (HHS). Methods Retrospective analysis of 36 cases of HHS patients with clinical data and treatment results. Results In HHS patients, the higher the age, the higher the sodium and serum osmotic pressure, the more the number of chronic diseases in the past, the more prone to MODS. Infection was the main cause of MODS, especially in the lung (43.42 %), Followed by improper treatment (26%) and cerebral infarction (13%). Thirty-six of 36 HHS patients died (33.3%), all of them were MODS patients with a mortality rate of 42.9%. The case fatality rate was 23.3% for 3 organ dysfunction, 55.6% for 4 organ dysfunction, and 100% for 5 or more organ dysfunction. Conclusion In HHS patients, infection is the main cause of MODS. MODS is the major cause of HHS. The mortality of MODS is related to the number of dysfunction organs.