摘要
老年多器官衰竭(multiple organ failure in the elderly,MOFE)是有别于以创伤等为主导因素、多见于中青年人的多器官衰竭(multiple organ failure,MOF)的新的临床综合征。作者结合12年来收治的158例MOFE病例,对其定义、范围,诊断标准和分期、分型进行了初步探讨。提出的定义为:老年人≥60岁)在器官老化、功能低下和患有多种慢性疾病的基础上、由某种诱因激发,在短时间内出现两个或两个以上器官序贯或同时发生衰竭。其诱因以肺部感染和心、脑、肾等慢性疾病急性发作为常见。其器官序贯发生衰竭的时间间隔大多在10天之内而不超过1个月。在临床上可分为单相(速发)型、双相(迟发)型和多相(反复)型,而多相型是仅见于MOFE的特有类型。并对其范围、诊断标准和各型的特点等进行了讨论。
Multiple organ failure in the elderly (MOFE) is a new cilinical syndrome different from multiple organ failure (MOF) caused by trauma occurring most often in young and mid-aged persons. The authors retrospectiverly analysed 158 cases of MOFE hospitalized in the past 12 years and commented on its definition, diagnostic criteria, clinical patterns and stages. The suggested definition of MOFE is the sequential occurrence of 2 or more organs failure within a short period in the elderly patients(≥60 years old) with multiple organ chronic diseases in the presence of aging of organs and age related malfunction. The most common precipitating factors are pulmonary infection and acute attack of chronic cardiac, cerebral or renal diseases. The interval between failures of various organs is mostly less than 10 days and seldom longer than 1 month. Usually, MOFE has 3 different patterns: rapid pattern with single phase; delayed pattern with two phases and recurrent pattern with multiple phases. In the last pattern the patients often suffer from multiple attacks of multiple organ failures. This pattern is only seen in MOFE, but not in MOF. The presentation of this particular pattern is related to the following facts:(1)A few organs, or only heart and lungs, are involved; (2)Kidney, brain and hemopoetic system etc, usually with poor prognosis, are not involved; (3)The age of patients are relatively younger; (4)More resuscitation experiences have been accumulated aed better suscitation measures are available. The clinical course of MOFE can be divided into 3 stages: prefailure stage (stage Ⅰ), failure compensation stage (stage Ⅱ) and decompensation stage (stage Ⅲ). Some problems about the dignostic criteria and the characterstics of diffent patterns and stages have also been discussed.
出处
《军医进修学院学报》
CAS
1990年第3期193-198,共6页
Academic Journal of Pla Postgraduate Medical School
关键词
多器官衰竭
老年医学
诊断
分类
Multiple organ failure Geriatrics Diagnosis Classification
