多器官功能障碍综合征.pptVIP

多器官功能障碍综合征;本章要求：;;HistoryReview;HistoryReview;名称作者年份;主要教学内容;第一节、概论(outline);一、概述(GeneralConsiderations）;1、病因(etiologicalfactor):

任何能引起SIRS的疾病均可发生MODS

感染性病因70%，非感染性30%.

?创伤(trauma)

?手术(operation)

?感染(infection)(mainfactor)

?休克(shock)

?出血性坏死性胰腺炎

(necrotizingpancreatitis)

;发病机制的六种学说;发病机制;2、发病机制（pathogenesis）;二、临床表现（ClinicalFindings）;第十五页，共一百零三页。;2、Typing:

?Quicklytyping:

emergencycaseafter24hourappeartwoormoreorgan-systemdysfunction

?Slowlytyping:

earlieroneorgandysfunction,subsequentlytotakeplacemore

organ-systemdysfunction

;第十七页，共一百零三页。;三、诊断（Diagnosis）;诱发MODS主要高危因素;;诊断要点;PreliminaryassessmentofMODS;诊断标准;DiagnosticCriteriaforSignificantOrganDysfunction

OrganSystemCriteria

Pulmonaryneedformechanicventilation;PaO2/FiO2ratio

200mmHgfor24h

CardiovascularNeedforinotropicdrugstomaintain

adequatetissueperfusion;CI2.5L/min/m2

KidneyCreatinine3mg/dL(250)on2consecutivedor

needforrenalreplacementtherapy

LiverBilirubin30mg/L(51.3)on2consectivedor

PT15control

CNSGlasgowComaScalescore7withoutsedation

CoagulationPlateletcount50×109/L;Fibrinogen

100mg/dLorneedforfactorreplacement

;CI:cardiacindex;

CNS:centralnervoussystem;

PT:prothrombintime;

FiO2:fractionofinspiredoxygen;

PaO2:partialpressureoxygen;四、预防（Prevention）;100

90

80

70

60

50

40

30

20

10

0

12