早在80年代初期,MOF被认为是不能控制感染的致死性表现,但到中期发现MOF可发生在无感染的情况下,由此提出“脓毒性综合征”和细菌移位为创伤后MOF等起动机制的解释.在巨大创伤后,伤员处于炎症亢进状态,现称之为全身性炎性反应综合征(SIRS).作者提出“打击”学说,广泛创伤可引起严重SIRS, 即可发展成MOF(“一次打击”模式);而不太严重的创伤引起中度SIRS(第一次“打击”),后者引起延迟中度免疫抑制,继发炎性损害(第二次“打击”)增加SIRS程度而产生MOF(两次“打击”模式).为了早期检出MOF的危机因子要重视第一次打击和SIRS的表现.组织损伤指标可作为第一次“打击”严重度的指标,如腹腔损伤(腹腔创伤指数>15分)可发生 As early as the early 1980s, MOF was considered to be a lethal manifestation of uncontrollable infection, but by the midterm it was found that MOF could occur without infection, thereby suggesting “septic syndrome” and bacterial translocation as post-traumatic MOF After the huge trauma, the wounded are in an inflammatory state, now known as systemic inflammatory response syndrome (SIRS). The authors propose a “strike” theory, extensive trauma can cause severe SIRS, which can be developed into MOF (“One-hit” mode); less severe trauma causes moderate SIRS (the first “hit”), which leads to a delay in moderate immunosuppression, secondary inflammatory damage (second “hit”) increases SIRS (Two “hit” modes) .In order to early detect the crisis factors of MOF, we should pay attention to the performance of the first strike and the SIRS.The indicators of tissue damage can be used as the first indicators of the severity of “hit”, such as the abdominal cavity Injuries (abdominal trauma index> 15 points) can occur