Effect of early intervention on containment of secondary multiple organ dysfunction syndrome
10.3969/j.issn.1008-9691.2014.04.008
- VernacularTitle:早期干预对遏制继发性多器官功能障碍综合征的影响
- Author:
Huiqing RAO
;
Daoyong HUANG
;
Yingfei HUANG
;
Qian LIANG
- Publication Type:Journal Article
- Keywords:
Early intervention;
Secondary;
Multiple organ dysfunction syndrome;
Hemorheology
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2014;(4):270-273
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effect of early intervention on patients with severe illness deterioration induced multiple organ dysfunction syndrome(MODS). Methods 184 severe patients were randomly divided into conventional treatment and intervention groups(each,92 cases). Active treatment of primary disease and symptomatic treatment were given to the patients in the control group,and based on the treatment of the above group, low dose heparin was additionally given to the observation group for anticoagulation to change hemorheology. Before and after treatment for 1 week,life signs,blood routine test,blood biochemistry,blood coagulation index,D-dimer, hemorheology,blood gas analysis and acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score were observed in two groups to judge the overall changes of disease situation. The length of stay in intensive care unit(ICU), the incidence of MODS and mortality after 1 week treatment were compared between the two groups. Results The levels of platelet count(PLT),fibrinogen(Fib),D-dimer,whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity,white blood cell count(WBC),arterial blood lactate(Lac),alanine aminotransferase (ALT),serum creatinine(SCr),APACHE Ⅱ score in two groups after the treatment were decreased significantly, while oxygenation index(PaO2/FiO2),mean arterial pressure(MAP)were increased significantly,and the observation group improvement was better than that of the control group〔PLT(×109/L):180.74±85.59 vs. 214.33±78.68,Fib (g/L):3.15±0.83 vs. 3.22±1.89,D-dimer(g/L):0.35±0.17 vs. 0.72±0.25,whole blood high shear viscosity (mPa · s):5.54±2.26 vs. 6.73±2.48,whole blood low shear viscosity(mPa · s):8.56±2.12 vs . 11.76±3.45,plasma viscosity(mPa · s):1.35±0.24 vs. 1.82±0.50,WBC(×109/L):10.75±5.53 vs. 14.34±8.66,PaO2/FiO2(mmHg, 1 mmHg=0.133 kPa):288.52±85.34 vs. 216.34±97.72, MAP(mmHg):99.52±20.85 vs. 90.73±21.86, Lac (mmol/L):2.72±1.08 vs. 4.46±2.87, ALT (U/L):89.73±22.45 vs. 125.23±77.48, SCr (μmol/L):110.19±35.26 vs. 140.23±68.96,APACHEⅡscore:13.29±3.74 vs. 18.45±3.52,all P<0.05〕;in the control group,the activated partial thromboplastin time(APTT)after treatment was decreased significantly(s:40.76±9.89 vs. 42.39±12.47),while in the observation group,increased(57.50±7.12 vs. 41.74±13.62). Compared with the control group,the length of stay in ICU was shortered(days:4.1±1.5 vs. 4.6±2.3,P<0.05),the incidence of MODS (22.8% vs. 46.7%,P<0.05)and mortality(6.5% vs. 14.1%,P<0.05)were reduced significantly in observation group. No serious complications occurred in two groups. Conclusion Anti-coagulant used for early intervention can control the disease progress and prevent the patients with severe disease from further deterioration,thus it may reduce the incidence of secondary MODS and mortality,shorten the duration of hospitalization in ICU and save the cost.
