Clinical Analysis Of Patients With Multiple Organ Dysfunction Syndrome After Actue Cerebrovascular Disease

The conception of Multiple Organ Dysfunction Syndrome (MODS) means the patient who had normal function appears two or more systems and organs dysfunction when he receive severe trauma, shock, infection or surgical operation after 24 hours for acute damage. It is a new conception which raised in surgical domain in the'70s of last century, because it has high mortality and difficulty in cure, it is one of the hotspot in medical science.The research before was in septicemia, sepsis or severe trauma, but after deep study the noninfectious reason has being focus on. Modern epidemic investigations indicated the morbidity of cerebral vascular disease(CVD) has being raising annually, CVD,heart disease and malignant tumor are the top three fetal disease in the world. It had be considered the cause of death in acute cerebral vascular disease had been cerebral hernia due to high volume cerebral hemorrhage and a large area cerebral infarction, but after medical treatment has been elevated and research had been profound, it has been confirmed that only a small part of the patients had been dead for primary cerebral damage in acute cerebral vascular disease(cerebral hernia, central respiration and circulation exhaustion), most of them had died of combing MODS after ACVD.The normal treatments can't improve the prognosis of MODS after ACVD, but the new therapies had not been applicating in clinic. So to recognize MODS after ACVD thoroughly, make sure the features of clinic and the risk factors which impact prognosis and protect the organ functions who easily has MODS is very important, and it is key to reduce the fatality rate of MODS after ACVD.Objective: The research is to discuss the clinical information of 71 patients with MODS after ACVD, to reveal the clinical features and the factors which effect prognosis, and thus can provide theoretical and clinical basis for further study and the therapy in MODS after ACVD.Methods: 71 patients with MODS after ACVD whose clinical information was integrated were analyzed retrospectively from 01-2003 to 01-2007, all were treated at the Neurology Department of the First Clinical Hospital of Jilin University, and designed statistical tables, recorded the detail information of every case including patient's age, sex, primary chronic diseases, precipitating factors, the first and multiple disorder organs, number of disorder organs, clinical stages, life sign and laboratory examination, complications and prognosis and so on. Then, the data were collected according to each element studied, the comparable data were statistically analyzed, educed results, and draw a conclusion.Results: The mortality of MODS after ACVD is 59.15%, higher than who don't have MODS(8.43%). MODS after ACVD patients had some primary chronic disease, the most is hypertension, diabetes mellitus, strokes, coronary artery disease, 2.08 on the average. Infection is the most common precipitating factors, and the rate of pulmonary infection is 86.67%, which is the most. MODS after ACVD patients usually had some complications such as hypoxemia, hypoproteinemia, acid-base disturbances and so on. There is significant difference in the nature of cerebral vascular disease. It is obviously higher in the 60 years older group than 60 years elder group. The mortality increased gradually, following the number of disorder organs rose, had normal phase correlation. The sequence of first disorder organs were stomach and bowel, heart, lung, kidney and metabolism, and the sequence of multiple disorder organs were stomach and bowel, heart, lung, kidney, metabolism and hematological system, the sequence of first and multiple disorder organs were the same, it had some predictability, and it was stomach and bowel, was different with the other causes of MODS, so it had some predictability. To prevent and cure pulmonary infection actively, incision of trachea can degrade the mortality of excessive phlegm patients. To protect stomach and bowel, especially in stress ulcer can degrade the morbidity and mortality of MODS after ACVD patients.Conclusions: 1. MODS after ACVD is the main death cause in cerebral vascular patients. 2. complicate with precipitating factors or not, the number of disorder organs can effect the mortality of MODS after ACVD patients. 3. Stomach and bowel is the first and multiple disorder organs of MODS after ACVD patients.