Clinical Analysis Of 35 Patients With MODS

Multiple organ dysfunction syndrome (MODS) has been the most commonly complication caused by some critical disease such as post-trauma,severe infection,extensive burn and necrotizing pancreatitis in the past 30 years since Tilney initially described this syndrome as "sequential system failure" in 1970s,and it represented the primary cause of death in the intensive care unit.We conducted the risk factors of death, common etiological factors, sequence of organ failure, pattern of syndrome of the Traditional Chinese Medicine(TCM) to inquire into the risk factors leading to fatality of MODS patients and the effect of traditional Chinese and western medicine (TCM-WM) on MODS for elevating the achievement ratio of rescuing the patient by analyzing the data of the 35 MODS patients.Results: the mortality of MODS is 34.3%,and the mortality increases with the number of failed organs; Age,chronic disease,score of APACHE II,low temperature are the high risk factors correlated with the mortality of MODS. Respiratory failure is most commonly the first failure organ(37.1%),and in the next place is the heart and kidney which both take up 20 percent.Infection is the main predisposing factor of MODS(40.5%) and pulmonary infection is ranked the first(37.5%).According to differentiation of syndrome in TCM,we found there are four common types of syndrome on MODS:sthenic heat syndrome,stagnancy of Blood and Qi syndrome,Yangming fu-organ syndrome,depletion of Yin and Yang syndrome,taking up 40.0%, 31.4%, 45.7% and 45.7%respectively. There are three major types of syndrome appearing in all process of disease :sthenic heat syndrome ,blood stasis syndrome and Yangming fu-organ .Among all 18 patients have two types of syndrome ,and 2 patients have three;the mortality of whom have only one type of syndrome is 13.3%,and others 50%.Conclutions:the effect of TCM-WM on MODS is better than WM only.Controlling infection especially pulmonary infection should be strengthened in the therapy of MODS.Actively treating primary disease may decrease the mortality .Because lung and heart have high morbidity in first and single organ failure,we should protect and support them in the early stage. Comprehensive therapy of cleaning heat and removeing toxic substance,promoting blood circulation to remove blood stasis,relieving constipationby purgation,warming Yang and invigorating Ying may block and delay the process of MODS ,decrease mortality.Improving the circulation of capillary vessel may have great meaning...