80岁以上高龄患者肺部感染并发老年多器官功能不全综合征的临床研究

Multiple organ dysfunction syndrome induced by pulmonary infection in patients over 80 years old

摘要:

目的 探讨＞80岁的高龄患者肺部感染并发老年多器官功能不全综合征（MODSE）的临床特点。方法 对2006年1月至2013年12月在解放军白求恩国际和平医院住院的97例＞80岁的肺部感染并发MODSE患者进行回顾性调查，分析所患慢性基础疾病及受损器官情况。结果 97.94%的病例患有＞3种慢性基础疾病，最多者患有10种慢性基础疾病。12.37%的病例处于衰竭前期，87.63%的病例处于衰竭期。45.36%的病例受损器官≥4个，最多者受损器官达到6个；受损器官以肺、心、肾、外周循环、胃肠等较为常见，肺受损病例最多、占87.63%；在受损器官中，肺、心、胃肠、外周循环等器官＞90%处于衰竭期。首衰器官涉及肺、心、肾、胃肠等4个器官，以肺居首位；原有功能不全的器官首衰率高于原有功能正常的器官（P＜0.05）。结论 ＞80岁的高龄患者肺部感染并发MODSE，具有合并慢性基础疾病多、受损器官多、器官受损程度重等特点。首衰器官以肺居首位，其他原有功能不全的器官也有较高的首衰率。

Abstract:

Objective To explore the clinical features of multiple organ dysfunction syndrome in the elderly (MODSE) induced by pulmonary infection in the patients over 80 years old. Methods A retrospective study was carried out on 97 patients over 80 years old with MODSE induced by pulmonary infection in our department from January 2006 to December 2013. Their chronic diseases and involved damaged organs were analyzed. Results Among the 97 cases, 97.94% were accompanied with more than 3 chronic diseases, and some even were accompanied with 10 chronic diseases. There were 12.37% cases at early failure stage and 87.63% at the failure stage. There were 45.36% cases having more than 4 involved organs, and some even had 6 damaged organs. Lungs, heart, kidneys, peripheral circulation and gastrointestinal tract were commonly damaged, and the lungs were the most common, accounting for 87.63%. In the damaged organs, more than 90% of the lung, heart, gastrointestinal tract and peripheral circulation were at the failure stage. The first failure organ of MODSE induced by pulmonary infection included lung, heart, kidney and gastrointestinal tract in the cohort, and the lungs took first rank. The incidence of first failure of certain organ was higher in the patients with organ dysfunction than those with normal organ function (P＜0.05). Conclusion MODSE induced by pulmonary infection in the patients over 80 years old is characterized with more chronic diseases, damaged organs, and serious damage. The lungs are the most commonly involved first failure organ, and the other dysfunction organs also have higher rates of first failure.