摘要
目的：探讨烧伤后全身炎性反应综合征（SIRS）的诊断、治疗以及对多脏器功能失常综合征（MODS）转归的影响。方法：根据美国胸科医生学会（ACCP）和危重病医学会（SCCM）制定的标准诊断，同时参照APACHEⅡ评分系统、烧伤严重程度、全身感染情况等确定SIRS的严重程度。治疗方法分为烧伤休克的治疗、全身治疗和创面治疗3部分进行。结果：263例中，轻、中度SIRS135例（51．3％）；重度SIRS128例（48．7％），APACHEⅡ评分均＞10分。发生各种严重并发症41例（15．6％），其中并发MODS18例，占并发症发生率的43．9％；死亡19例（7．22％），128例重度SIRS中死亡17例，占死亡总数的89.5%。结论：严重烧伤后由于二次打击因素的存在,SIRS发生率高，与MODS的发病和预后密切相关。高度重视SIRS向MODS转变过程中的高危因素，阻断或消弱二次打击是防治SIRS最有力的措施。
Objective:To investigate the diagnosis and treatment of burned patients with systemicinflammatory response syndrome (SIRS),and the influence of SIRS on the development of multiple organ dysfunction syndrome (MODS). Methods:SIRS was diagnosed in accordance to ACCP and SCCMcriteria,the degree of SIRS was evaluated according to APACHE Ⅱ system,severity of burns,and systemic infection. Results:Among 263 patients who were diagnosed as having SIRS,the seventy of SIRSwss mild or moderate in 135 cases (51. 3% ),severe in 128 cases (48. 7% ). APACHE Ⅱ was exceeding10 points in severe patients. Severe complications occurred in 41 cases (15. 6% ), 18 of them developedMODS (43. 9% ). In this study, 19 patients (7. 22% ) died of severe SIRS during observation period.Conclusions: The incidence of SIRS appears to be high in patients with major burns due to two - hit phenomenon,which is associated with the development of MODS. Therefore,more attention should be paidto the risk factors which were responsible for the progression of SIRS to MODS,and the effective strategy for the treatment of SIRS would be blocking or mitigating the two - hit process.
出处
《中国危重病急救医学》
CAS
CSCD
1998年第3期148-150,共3页
Chinese Critical Care Medicine
关键词
灼伤
SIRS
诊断
治疗
burns
systemic inflammatory response syndrome
