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1 多系统器官衰竭的基本概况多系统器官衰竭是七十年代后开始为人们注意的一个新的临床综合征.最早描述的是Tilney(1973)报导一组腹部大动脉破裂病人术后相继出现肾、肺、肝、心、脑及消化道的严重病变.其死亡率达95%.当时他称之为序贯性系统衰竭(Sequential SystemFailure)、随后Baue(1975)报导了类似情况,称为多发性进行性或序贯性系统衰竭(Multiple Progre-ssive or Sequen tial System failure).Fiseman(1977)则命名为多器官功能衰竭(MOF),Fry(1980)称这种临床现象为Multiple System organfailune(MSOF).目前通称MOF或MSOF.MSOF是由于多因素引起多器官功能衰竭的严重综合征,涉及的机体生理改变非常广泛,除心、肺、肝、肾、脑及消化道等重要器官外,同时也影响神经系统、骨骼、肌肉、血液和内分泌系统以及免疫、网状内皮系统的功能.MSOF在外科急症手术后的发病率约7～22%,在腹腔感染败血症则为30～50%,其死亡率的高低与衰竭器官的数目有关,Fry等提到单器官衰竭为23%,两器官53%,三器官79%、四个器官100%.
1 The basic situation of multi-system organ failure Multi-system organ failure is a new clinical syndrome that began to notice after the seventies.It was first described that Tilney (1973) reported that a group of patients with ruptured abdominal aorta developed kidney, Serious lesions of the lungs, liver, heart, brain and digestive tract, with a 95% mortality rate, were then referred to as Sequential System Failure and subsequently Baue (1975) reported a similar condition called multiple Multiple Progression-Sequential System Failure. Fiseman (1977) was named Multiple Organ Failure (MOF) and Fry (1980) described this clinical phenomenon as Multiple System Organ-Mailune (MSOF) Currently known as MOF or MSOF.MSOF is a multifactorial syndrome caused by multiple organ failure, involving a wide range of physiological changes in the body, in addition to heart, lung, liver, kidney, brain and other important organs of the digestive tract, Affecting the function of the nervous system, bone, muscle, blood and endocrine system as well as the immune, reticuloendothelial system.The incidence of MSOF after surgical emergency surgery is about 7 to 22% It is 30 to 50%. The mortality rate is related to the number of failing organs. Fry et al. Referred to 23% of single organ failure, 53% of two organs, 79% of three organs, and 100% of four organs.