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目的 :探讨急性脑血管病 (ACVD)并发多脏器功能衰竭 (MOF)的临床特点、发病机理、防治措施 ;总结治疗经验 ,便于临床医生更好地认识本病。方法 :系统分析 1996年 1月至 2 0 0 0年 12月我院神经内科病房收治的 12 0例ACVD并发MOF的临床资料。包括发病年龄、既往病史、MOF发生时间、发生率、病死率 ,比较脑出血组 (含蛛网膜下腔出血 ,70例 )与脑梗死组 ( 5 0例 )并发MOF与病死率之间的关系。结果 :提示高龄、有慢性病史、脑损害的部位和轻重与MOF发生关系密切 ,尤其当病变影响丘脑下部、植物神经和内分泌功能明显障碍时 ,MOF在所难免 ;脏器衰竭数目与MOF病死率呈正相关 ;脑出血组并发MFO病死率明显高于脑梗死组 (P <0 0 1)。结论 :为降低MOF的发生率 ,对ACVD患者应采取积极正确的治疗及严密的观察 ,一旦发生MOF ,则应采取紧急措施加以控制。治疗中应早期常规进行有关器官功能监测 ,积极有效地控制脑、呼吸、循环、肾功能衰竭。本病预后极差 ,预防ACVD后的MOF的发生至关重要 ,积极有效的综合治疗是减少MOF死亡的重要环节
Objective: To investigate the clinical features, pathogenesis, prevention and treatment of acute cerebrovascular disease (ACVD) complicated with multiple organ failure (MOF). To summarize the experience of treatment so that clinicians can better understand the disease. Methods: The clinical data of 120 cases of ACVD concurrent MOF admitted from Department of Neurology of our hospital from January 1996 to December 2000 were systematically analyzed. Including age of onset, history of previous illness, time of onset of MOF, incidence, mortality, the relationship between MOF and mortality in patients with cerebral hemorrhage (subarachnoid hemorrhage, 70 patients) and cerebral infarction patients (50 patients) . Results: It is suggested that MOF is inevitable when MOF is closely related to the location and severity of brain damage, especially in the cases of lesions affecting the lower part of the hypothalamus, autonomic nerves and endocrine dysfunction. The number of organ failure and MOF mortality The incidence of MFO complicated by cerebral hemorrhage was significantly higher than that of cerebral infarction (P <0.01). Conclusion: In order to reduce the incidence of MOF, positive and correct treatment and close observation should be taken for patients with ACVD. In the event of MOF, emergency measures should be taken to control them. Early treatment of organ function should be routinely monitored, and actively control the brain, respiratory, circulatory, renal failure. The poor prognosis of this disease, prevent the occurrence of MOF after ACVD is essential, active and effective comprehensive treatment is to reduce the mortality of MOF an important part