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目的 :提高对高原地区危重病患者发生全身炎症反应综合征 (SIRS)和多器官功能障碍综合征 (MODS)的认识 ;方法 :分析 2 6 6例SIRS患者的临床资料 ,患者至少符合 2项SIRS标准 ,包括发热或体温过低、心动过速、呼吸急促、白细胞计数异常 ;MODS的诊断标准是 ,机体受打击 2 4小时后出现两个或两个以上器官功能不全 ;结果 :2 6 6例中符合 2项标准者 6 9例 (2 5.9% ) ,3项者 1 0 2例 (38.3% ) ,4项者 95例 (35.7% ) ;发展为MODS的有 6 5例 (2 4.4% ) ,其中 2项的有 9例 (1 3.0 % ) ,3项的有 2 6例 (2 5.5% ) ,4项的有 1 5例(1 5.8% ) ;死亡 40例 (1 5.0 % ) ,其中SIRS 2项的 5例 (7.2 % ) ,3项的 2 0例 (1 9.6 % ) ,4项的有 1 5例 (1 5.8% ) ;二脏衰死亡 7例 (2 8.0 % ) ,三脏衰死亡 2 1例 (77.8% ) ,四脏衰死亡 7例 (87.5% ) ,五脏衰以上死亡 5例 (1 0 0 % ) ;结论 :SIRS可由感染和非感染因素引起 ,病情进展可发展为MODS。高原地区由于缺氧 ,发生SIRS符合 3项标准者为多 ,且在这一项中并发MODS和死亡率均高 ,建议完善高原地区SIRS诊断标准
OBJECTIVE: To improve the understanding of SIRS and MODS in critically ill patients in the plateau area.Methods: The clinical data of 266 SIRS patients were analyzed. The patients were at least eligible for 2 SIRS Standard, including fever or hypothermia, tachycardia, shortness of breath, abnormal white blood cell count; MODS diagnostic criteria is that the body hit two to four hours after two or more organ dysfunction; Results: 266 cases Among them, 69 (2 5.9%) were eligible for 2 criteria, 102 (38.3%) were 3 items, and 95 (35.7%) were 4 items. Sixty-five (24.4%) patients developed MODS, , Of which 9 cases (13.0%) were found in 2 cases, 26 cases (23.5%) in 3 cases, 15 cases (1 5.8%) in 4 cases and 40 cases (15.0%) in 4 cases 5 cases (7.2%) of SIRS 2 items, 20 cases (1 9.6%) of 3 items and 15 cases (1 5.8%) of 4 items, 7 cases (2 8.0% (77.8%), death of four organs (7.5%) and death of five internal organs (100%). CONCLUSIONS: SIRS may be caused by both infectious and noninfectious factors. The progression of the disease may develop into MODS. Due to lack of oxygen in the plateau, SIRS meet the three criteria were more, and in this one were complicated by MODS and mortality, it is recommended to improve the diagnostic criteria SIRS Plateau