| 胆石症术后MSOF临床救治 |
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| 引用本文： | 高炳豪,杜闯,董大海,辛革,蔡斌,陶乃文.胆石症术后MSOF临床救治[J].大连大学学报,1991(1). |
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| 作者姓名： | 高炳豪 杜闯 董大海 辛革 蔡斌 陶乃文 |
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| 作者单位： | 大连友谊医院外科，大连友谊医院外科 |
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| 摘 要： | 本文作者按照 Fry(1988年)的诊断标准,并参考张时纯所修正的标准,回顾性总结了近五年收治并行手术,治疗较系统的胆石症术后合并 MSOF 21例;全组病例均于术后1～7天,平均2天发生 MSOF;并都伴有不同程度休克,受累器官顺序依次肺、肝、肾、心脏及消化道。发生二衰者15例.病死率40%(死亡6例)二衰者6例,病死率83.3%(死亡5例)。作者以休克致 MSOF 的发生机制,引用单相速发型的概念,分析了本组大多数属于此类型。重点谈了黄疽与肝衰、肾衰的关系;认为梗阻性黄疽病人术后急性肾衰发生率与黄疽程度有密切关系,主张术前、术后尽量设法控制胆质血症。使胆红素降至4.0mg/dL 以下,可降低肾衰的发病率及死亡率。在 MSOF 教治中,主张积极抗休克,大剂量保肝药物应用,同时扩张肾血管,对 ARDS 病人争取早期气管切开。并认为由胆道感染和低血压所致心肌缺血及心律失常的病人及一些术前心动不全的老年人术后可能会发生心衰,故主张除一般强心措施外,重在早期认识和预防。
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| 关 键 词： | 胆石症 MSOF 休克 高胆红素血症 |
The Learning from the Clinical Treatment for MSOF After the Cholelithiasis Operation |
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| Gao Binghao Du Chuang Dong Dahai Xin Ge Cai Bin Tao Naiwen.The Learning from the Clinical Treatment for MSOF After the Cholelithiasis Operation[J].Journal of Dalian University,1991(1). |
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| Authors: | Gao Binghao Du Chuang Dong Dahai Xin Ge Cai Bin Tao Naiwen |
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| Institution: | Gao Binghao Du Chuang Dong Dahai Xin Ge Cai Bin Tao Naiwen |
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| Abstract: | According to the diagnosis standard of Fry (1988),and as well as the standard revised by zhang shicun,the present paper has sumed up the expe- rience with the clinical treatment for MSOF after the cholelithiasis operation nearly in the period of five years.Also in the paper,the causes of MSOF has been anlaysed,and the way in which MSOF is treated and prevented have been approched. |
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| Keywords: | Cholelithiasis MSOF Clinical treatment |
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