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我科1986至1990年收治危重型急性脑血管病并发MSOF215例(男153例、女62例),其中60～70岁110例,占51.1％。既往史以高血压最多,113例占52.6％,出血87例,梗塞102例,SAH26例。死亡161例占74.9％。作者分析了215例急性危重型脑血管病合并MSOF的临床表现、不同器官衰竭的频度、顺序及器官衰竭数目与预后的关系。危重型脑血管病合并MSOF主要原因为脑水肿,尤为高颅压所致神经体液调节紊乱。另外,在缺血性中风再灌注后脑损伤,通过Ca~(2+)自由基、白细胞三烯等机制可进一步加重脑水肿和高颅压。在治疗方面应强调脱水剂、激素、抗自由基、钙离子拮抗剂、莨菪类药物的联合应用,并对重症脑血管病急性期严密监测生命体征、脑电图和心电图等。
Our department from 1986 to 1990 admitted MSOF215 cases of acute cerebrovascular disease (153 males and 62 females), of which 110 cases of 60 to 70 years old, accounting for 51.1%. The past history of hypertension, 113 cases accounted for 52.6%, 87 cases of bleeding, 102 cases of infarction, SAH26 cases. 161 cases died of 74.9%. The authors analyzed the clinical manifestations of 215 patients with acute critical cerebrovascular disease complicated with MSOF, the frequency of different organ failure, the order and the relationship between the number of organ failure and prognosis. The main cause of MSOF with MSOF is cerebral edema, especially the disorder of neurohumoral regulation caused by high intracranial pressure. In addition, brain damage after ischemic stroke reperfusion, through Ca2 + free radicals, leukotrienes and other mechanisms can further increase cerebral edema and intracranial hypertension. Should be emphasized in the treatment of dehydration agents, hormones, anti-free radicals, calcium antagonists, combination drugs and other drugs, and severe acute cerebrovascular disease in close monitoring of vital signs, EEG and ECG.