【摘要】 目的分析产科急重症患者合并多系统器官功能衰竭(MSOF)的临床特点与诱发因素。方法对1995年以来收治的42例产科急重症患者合并MSOF病例作回顾分析,比较产科急重症合并MSOF发生情况、衰竭器官数目与病死率关系、各系统器官功能衰竭发生例次。结果导致MSOF的重度妊娠高血压疾病、产后出血、羊水栓塞、DIC、胎盘早剥及其他诱因中,重度妊娠高血压疾病诱发MSOF显著高于其他诱因(P<0.05);产科急重症患者合并发MSOF中,随着衰竭器官数目增加,其病死率增加,合并4、5个器官衰竭的产科急重症患者其病死率显著高于仅2个器官衰竭者(P<0.05);各系统器官功能衰竭发生率中,肾功能衰竭发生率显著高于其他系统器官衰竭(P<0.05)。结论产科危重症并发MSOF的治疗应积极预防和控制诱因,更应重视防治重度妊娠高血压疾病,必要时适时终止妊娠,对这类患者应采取有效措施防止衰竭器官数目的增加,以达到降低其病死率目的,产科危重症患者应特别注意采取必要措施预防肾功能衰竭的发生。更多还原

【Abstract】 Objective to analyze the clinical characteristics and causes for obstetrical patients suffering from severe and urgent MSOF.Methods to reflect on the 42 obstetrical cases of severe and urgent MSOF admitted into the hospital since 1995 by a comparison of the relationships between the cases of MSOF in the obstetrical ward,the number of failure organs and the death rate and also the number of occurrences of each system organ failure.Results factors causing MSOF,such as severe geslational hypertension,post partum hemorrhage,amniotic fluid embolism,DIC,placenlal abruption,etc,the severe geslational hypertension is remarkably higher than other factors(P<0.05);among the cases of severe and urgent MSOF in the Obstetrical ward,with the increase of the numbers of failure organs,the mortality rate is on the increase.The mortality rate for the severe and urgent cases of compound failure of 4 or 5 organs is remarkably higher than that for the cases of a compound failure of only 2 organs(P<0.05);among the occurrence rates of all the organs failure,the occurrence of kidney failure is remarkably higher than that of other organs(P<0.05).Conclusion The treatment of the obstetrical cases of severe and urgent MSOF should be in a method of prevention and causation control,and more attention should be paid to prevention and treatment of severe geslational hypertension,and pregnancy should be terminated when appropriate.The effective methods should be taken to prevent the increase of the number of the failure organs so as to decrease the mortality rate.Special attention should be paid to the prevention of kidney failure for the severe cases in the obstetrical ward.更多还原