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目的 提高恶性梗阻性黄疸病人全身炎症反应综合征 (SIRS)与多器官功能障碍综合征 (MODS)关系的认识 ,探讨MODS的防治策略。方法 分析 15 2例恶性梗阻性黄疸病人SIRS的临床资料 ,病人至少符合 2项SIRS诊断标准 ,包括发热、体温过低、心动过速、呼吸急促或白细胞计数异常。结果 术前出现SIRS者 5 8例 ,发生率 3 8 1% ,其后MODS发生率 3 6 2 % ,病死率为 13 8%。MODS中胃肠功能衰竭最常见 ,随着SIRS标准项目的增加 ,MODS的比例也增加 ,但差异不显著 (P >0 0 5 )。结论 早期诊断SIRS ,积极调控机体炎症反应 ,是改善恶性梗阻性黄疸病人预后的关键。
Objective To improve the understanding of the relationship between systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) in patients with malignant obstructive jaundice and to explore the strategy of prevention and treatment of MODS. Methods Clinical data of 15 SIRS patients with malignant obstructive jaundice were analyzed. The patients met at least 2 SIRS diagnostic criteria, including fever, hypothermia, tachycardia, shortness of breath or abnormal white blood cell count. Results There were 58 cases of SIRS preoperatively, the incidence rate was 38.1%, the incidence of MODS was 36.2% and the case fatality rate was 13.8%. Gastrointestinal failure in MODS was the most common. With the increase of SIRS standard items, the proportion of MODS also increased, but the difference was not significant (P> 0.05). Conclusion Early diagnosis of SIRS and active regulation of the inflammatory response in the body are the keys to improve the prognosis of patients with malignant obstructive jaundice.