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本文报道高海拔地区婴幼儿重症肺炎并发MSOF 192例,结果合并呼吸及心力衰竭100%,脑水肿81.6%,DIC 25.5%,胃肠功能衰竭0.7%。MSOF均在呼吸衰竭基础上发生,提示肺部重症感染、严重低氧血症与高碳酸血症是MSOF的重要原因;器官功能衰竭与预后呈正相关。器官衰竭数增多,病死率明显增高。病理资料表明,免疫功能障碍是婴幼儿重症肺炎并发MSOF致死的重要原因。有效的控制肺部感染,保持呼吸道通畅,高浓度给氧,及时气管插管是防治重症肺炎MSOF的关键。
This paper reports 192 cases of MSOF complicated by severe pneumonia in infants and young children in high altitude area. The results showed that respiratory failure and heart failure were 100%, cerebral edema was 81.6%, DIC was 25.5% and gastrointestinal failure was 0.7%. MSOF occurred on the basis of respiratory failure, suggesting that severe pulmonary infection, severe hypoxemia and hypercapnia is an important cause of MSOF; organ failure and prognosis were positively correlated. Increased number of organ failure, mortality was significantly higher. Pathological data show that immune dysfunction is an important cause of severe infant pneumonia complicated with MSOF. Effective control of lung infection, maintaining airway patency, high concentrations of oxygen, timely tracheal intubation is the key to prevention and treatment of MSOF severe pneumonia.