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目的 探讨创伤性多器官功能衰竭 (MOF)的治疗。 方法 回顾分析 2 6例多发伤引起的MOF患者各器官衰竭的发生率、衰竭器官数量、治疗方法及血浆肿瘤坏死因子 (TNF)水平的变化与MOF死亡率的关系。 结果 2 6例MOF患者器官衰竭发生率以肺、心血管系统及肾最高 ,肝、消化道及中枢神经系统最低 ;2个器官衰竭死亡率为 2 5 .0 % ,3个为 36 .4% ,≥ 4个为 5 7.1%。血浆TNF在死亡病例保持较高水平 ,生存病例血浆TNF逐渐降低。大剂量地塞米松、6 5 4- 2联合应用可提高生存率。 结论 (1)创伤性MOF患者 ,衰竭器官的数量越多 ,死亡率越高。 (2 )血浆TNF水平升高与MOF的发生及死亡有关 ;(3)在积极保护和支持各主要器官功能基础上 ,联合大剂量应用地塞米松、6 5 4- 2 ,对防治MOF有重要作用。
Objective To investigate the treatment of traumatic multiple organ failure (MOF). Methods The incidence of organ failure, the number of organ failure, the treatment method and the level of plasma tumor necrosis factor (TNF) in 26 patients with MOF were retrospectively analyzed. Results The incidence of organ failure in 26 patients with MOF was the highest in lung, cardiovascular system and kidney with the lowest in liver, digestive tract and central nervous system. The mortality rate of organ failure was 25.0% and 36.4% , ≥ 4 for 5 7.1%. Plasma TNF remained high in deaths and plasma TNF decreased in survivors. High-dose dexamethasone, 6 5 4- 2 combination can increase the survival rate. Conclusion (1) Traumatic MOF patients, the more the number of failing organs, the higher the mortality rate. (2) The increase of plasma TNF level is related to the occurrence and death of MOF; (3) Dexamethasone combined with high dose of dexamethasone, 6 5 4 2, is important for the prevention and treatment of MOF on the basis of active protection and support of the major organ functions effect.