南昌大学医学院急危重症护理学课件 MODS.ppt

Emergency Nursing Nursing Department of Nanchang University He Xueying Key Terms Sepsis 败血症 Mortality 死亡率 Morbidity 发病率 Insult 损害 Homeostasis 内环境稳态 Hemorrhagic shock 出血性休克 Pancreatitis 胰腺炎 Systemic inflammatory response 全身炎性反应 Cytokine 细胞因子 Cirrhosis 肝硬化 Tachypnea 呼吸急促 Hypoxia 缺氧 Hypoxemia 低氧血症 Cyanosis 发绀、紫绀 Teaching objectives and demands 1、To grasp the concept and characteristics of MODS. 2、Master the clinical manifestation of MODS, assessment, monitoring and main points of nursing. 3、To familiar or comprehend the etiology and pathology of MODS. 4、Understand how to control and prevent MODS. Preface MODS：Commences to be in use from 1992 to refer to the presence of altered organ function in a severely ill patient so that homeostasis can not be maintained without intervention. MODS术语始用于1992年，是指在危重病人出现进一步的器官功能的异常改变，以至于如不予干预将不能维持内环境的稳定的综合症。 Overview MODS is a common complication in severely patient. It usually induced the majority patients to death. So it accounts for the majority of death in ICU.这就是ICU病人死亡率高的原因。 It is a new concept changed from multiple organs failure（MOF）. 为危重病人常见并发症，也是导致病人死亡的主要原因。因病人常出现多个器官衰竭而逐渐演变出来的一个新概念. Origin In 1973, Tilney firstly reported such a phenomenon: although 18 patients who suffered from the abdominal aneurysm rupture（腹主动脉瘤破裂） have had operating successfully, before long they occurred multiple organs and systems failure one after another, and then dying. The mortality were reached to 90%. Tilney called it sequential system failure. MOF and MSOF In 1975, Baue published a thesis titled 70’s syndrome—Multiple, progressive, or sequential systems organ failure. In 1976, Border named it as Multiple system organ failure，abbreviate MSOF. In 1977, Eiseman named it as multiple organ failure,MOF. MSOF(multiple system organ failure 1976~1991) MODS （multiple organ dysfunction syndrome） The patients who in the process of Severe wound、extensive burns、