摘要
本文总结了烧伤后并发多脏器功能衰竭41例临床资料。对烧伤休克、感染及伤前所患因疾病等素诱发多脏器功能衰竭进行了讨论,并提出烧伤多脏器功能衰竭的预防要点。
41 patients with extensive burns (23 male,18 female, age 1 9/12～84 years) complicated bySMOF were studied. Fourteen cases with MSOF (34.1%) happened in shock stage and 27 cases (65.9%) in infectious stage. Among them, 37 patients were associated with inhalationinjury. There were two organs affected in 29 cases, three ofgans in 6 cases and four organs in4 cases. Pulmanary function failures were found .in 29 cases, cardiac failures in 21 cases,gastrointestinal function failures in 19 cases, renal function failures in 16 cases,liver functiiofailures in 9 cases and coagulation function failures in 4 cases. Thirty cases died and 11cases survived. Discussion: 1. Shock was the principal cause to result in MSOF after burn injury. Ofthe 41 cases, 36 cases expressed a certain extent of shock in early stage. Metabolic disordermight occur in case that hypovolemic shock could not be corrected in two to four hours afterinjury. The destruction of the ultrastructure of the cells and the harmful effects of theoxygen free radical would finally result in MSOF. 2. Burn infection was the basis for developing MSOF. 27 cases were found that sepsisis the cause of MSOF. Injury of tissue cells caused by the necrotic tissue of the wound andthe endotoxin produced by bacterial infection would lead to MSOF. 3. The pre-existing disease of the organs prior to burn injury could directly lead to thefailure of the related organs. 4. The measures to prevent MSOF included: to correct hypovolemic shock as soon aspossible, to control local and systemic infections effectively, to strengthen whole body sup-portive therapy.
