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objective to raise the level of regarding congnition,prevention,diagnosis and therapy on multiple organ dysfunction syndrome.methods report the process and correlative therapy on one case who occured with mods involving 6 organs after hemorrhagic shock lead to heartbeat and respiration stopping suddenly and resuscitated resulting in left nephrostome titanium nip falled off accidentally from left kidney lymphatic fastening.at the same time,the author reviewed correlative literature and introduce the investigative progress about mods.results one case who happened with mods following hemorrhagic shock,heartbeat and respiration stopped suddenly was diagnozed and resuscitaed.6 organ dysfuncted including brain,heart,lung,liver,kidney and the digestive system.after being given therapy integrated chinese and western medicines,allopathy and nutritional treatment,all circadian parameters of the case came back in gear and discharged at last.conclusion the mechanism about mods is very complicated.because of serious infection,hurt and oxygen-lack,excessive inflammatery reaction activates multifarious cell factors and inflammatery mediums,which improve the happen-rate of mods.wiping off pathogeny,providing life-sustain treatment and recognising sirs and mods in time and adopting corresponding therapy,such as treatment integrated chinese and western medicines,can improve the hit-rate of cure on mods.
作者:王静恩,蔡金芳,王志华,谢晓洪多器官功能障碍综合征;中西医结合;治疗;休克,出血性目的提高对多器官功能障碍综合征(multiple organ dysfunction syndrome,mods)的认识、预防、诊断、治疗水平。方法报告成功抢救1例经腹腔镜左肾淋巴管结扎手术后左肾静脉钛夹意外脱落失血性休克,导致心跳呼吸骤停复苏后再手术并发mods累及6��脏器功能衰竭过程及有关治疗,并复习相关文献,介绍目前关于mods的研究进展。结果确诊1例因失血性休克心跳呼吸骤停复苏后并发mods,累及脑、心、肺、肝、肾、血液、胃肠等6个脏器。经积极采取中西医结合对症、支持救治,各生理指标全部恢复正常,康复出院。结论 mods的发生机制非常复杂,在严重感染、创伤、缺氧等打击下,失控的过度炎症反应激活多种细胞因子和炎症介质的释放,使mods发生率升高。尽早去除病因,尽早给予各种生命支持治疗,尽早对可能发生全身炎症反应综合征、mods识别并给予干预治疗,包括中西医结合治疗能改善mods的救治成功率。
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According to the scope of involving pathological changes, they are classified:① diffuse type: When the disease involves intrahepatic and extrahepatic bile duct, the duct wall incrassation and duct cavity appear,resembling withered arborization.
根据病变累及的范围分类①弥漫型:病变累及肝内外胆管,管壁增厚,管腔缩窄,呈枯树枝状。
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Mild to profuse diarrhea can occur. There may or may not be involvement of the nervous system.
可发生呼吸窘迫;可发生轻微至严重腹泻;可累及或不累及神经系统。
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Methods 93 patients(63 men and 31 women,average aged 36.6 years)with soft-tissue mass in the skin of scalp proved by surgical pathology(n=41),bioscopy(n=13) or clinic information(n=39) were analyzed.
将头皮软组织肿块定义为凡于颅骨外板之外的头皮中所形成软组织肿块,包含累及或未累及颅骨的肿块(不包含外伤性头皮血肿及新生儿产瘤、原发颅骨肿瘤)。
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There were 36 males and 40 females,with the average age of 47.7 years.36 patients presented with sciatica and perineal numbness,11 patients had painless mass and the other 20 were identified due to other causes.Among 67 benign neurogenic tumors,54 were originated from S1-S3 nerves,3 from S4-S5 nerves and 11 from the presacral space without caudal involvement.Giant cell tumor was found in 60 patients,which included 24 males and 36 females,with an average age of 32 years.Upper sacrum(S1-S2) was involved firstly.There were 56 patients(average,37.7 years) diagnosed as other primary benign bone tumors,which included 24 cases of teratomas,epidermoid cyst or dermoid cyst.Other malignant tumors,including chondrosarcoma (17),Ewing′s sarcoma/PNET(14),multiple myeloma(12),lymphoma(6) and osteosarcoma(6) were found in 64 patients.
其中脊索瘤95例,男62例,女33例,平均年龄55.7岁,骶尾区疼痛是主要症状(82例),半数以上患者伴有坐骨神经痛,肿瘤多先累及低位骶骨(S3~S5);神经源性肿瘤76例,男36例,女40例,平均年龄47.7岁,神经纤维瘤43例,神经鞘瘤24例,恶性神经鞘瘤9例,主诉多为坐骨神经痛、会阴部麻木(36例)和无痛性包块(11例),20例患者为查体或其他原因检查时发现,67例骶骨良性神经源性肿瘤起源于S3以上神经者54例,起源于S3以下神经者3例,发生于骶前未累及骶管者10例;骨巨细胞瘤60例,男24例,女36例,平均年龄32岁,腰骶尾部不适(37例)、坐骨神经痛(21例)是主要的临床表现,肿瘤多先累及上位骶骨(S1~S2);骶骨其他原发良性肿瘤及瘤样病变56例,包括畸胎瘤、皮样囊肿、表皮样囊肿共24例;其他原发恶性肿瘤64例,包括软骨肉瘤17例,尤文肉瘤14例,多发性骨髓瘤12例,成骨肉瘤6例等。
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Most tumors involved superficial subcutis (11 also dermis); only 3 were intramuscular.
绝大多数肿瘤累及浅表皮下组织(11例同时累及真皮);只有3例位于肌肉内。
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Results In 70 cases of primary hepatoma,20 cases involved portal vein and inferior vena cava; in 34 cases of pancreatic carcinoma, 29 involved vessels; and cholecystic carcinoma and gastric carcinoma never involved vessels.
结果 70例原发性肝肿瘤中20例累及门静脉或下腔静脉,34例胰腺癌中29例累及血管,胃癌及胆囊癌均未累及血管。
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Pathologic characteristic of supraglottic carcinoma spreading anterosuperiorly in l00 cas-es was investigated by whole-organ sections of the larynx. The results showed that 75%of supraglottic carcinomas were found to spread anterosuperiorly.In these cases, carcinoma in the epiglottis-ventricular fold accounted for 90%;epiglottic carcinoma 8l.8%; and carcinoma in the ventricular fold 33.3%.
采用喉连续切片技术重点观察100例声门上癌向前上发展的病理特点:声门上癌向前上发展平均为75%,其中会厌室带癌向前上发展的频度最高,为90%,会厌癌为81.8%,室带癌为33.3%,构会壁癌和构区癌未见向前上发展,声门上癌向前上发展以累及会厌前间隙为主,共6O例,其中累及会厌舌面为42例次,累及会厌谷为17例次,累及舌根为12例次,累及甲状软骨前上部为7例次。
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Results 7 patients accept skull CT/or MRI,There were 5 patients who had caudate nucleus and putamen injury in differ 3patients had Thalamus injury 2 patients were watershed with temporal-occipital lobe symptoms of all patients were able to control by take orally Haloperidol and Nitrazepam.
节果 7例均行头颅CT/或MRI检查,其中5例不同程啡累及尾状核和壳核,累及丘脑者3例,2例为累及颞枕叶的分水岭梗死,所有患者口服氟哌啶醇和硝基安定治疗,症状均能得到控制。
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Finally the pathological change implicates the lung section bronchial tube pulmonary alveolus fills in the cleaning solution cd3 t cell obviously to be lower than does not have the lung section group which the pathological change implicates, cd4 t cell, cd4/cd8, the nk cell obviously to be lower than the opposite side lung section group which the pathological change has not implicated.
结果 病变累及的肺段支气管肺泡灌洗液中cd3t细胞明显低于没有病变累及的肺段组,cd4t细胞、cd4/cd8、nk细胞明显低于病变没有累及的对侧肺段组。
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rheumatic endocarditis:风湿性心内膜炎
1.风湿性心内膜炎 风湿性心内膜炎(rheumatic endocarditis)常侵犯心瓣膜,其中二尖瓣最常被累及,��次为二尖瓣和主动脉瓣同时受累. 三尖瓣和肺动脉瓣一般不被累及. ���索和左心房壁内膜有时也可被侵犯. 2.风湿性心肌炎 风湿性心肌炎(rheumatic myocarditis)主要累及心肌间质结缔组织.
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FOCAL:局灶性
弥漫性(diffuse)肾炎指病变累及全部或大多数(通常为50%以上)肾小球;局灶性(focal)肾炎指病变仅累及部分(50%以下)肾小球;球性(global)病变累及整个肾小球的全部或大部分毛细血管绊;节段性(segmental)病变仅累及肾小球的部分毛细血管袢(不超过肾小球切面的50%).
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rheumatic pancarditis:风湿性全心炎
风湿病时病变常累及心脏各层,故称为风湿性全心炎(rheumatic pancarditis). 1.风湿性心内膜炎 风湿性心内膜炎(rheumatic endocarditis)常侵犯心瓣膜,其中二尖瓣最常被累及,��次为二尖瓣和主动脉瓣同时受累. 三尖瓣和肺动脉瓣一般不被累及.
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perichondritis:软骨膜炎
此病在文献中曾被称为多发性软骨炎(polychondritis)、软骨膜炎(perichondritis). 结节性多动脉炎(polyarteritis nodosa)是一种以坏死性血管炎为特征的累及多系统、多器官的少见的疾病. 主要累及小动脉和中等大小动脉,也可累及毛细血管和静脉.
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focal dystonia:局限性肌张力障碍
按肌张力障碍累及的躯体范围分类:(1)局限性肌张力障碍(focal dystonia): 指累及躯体的某一部分的肌张力障碍,如累及眼睑、下面部、咽喉部、颈部、躯干、肢体的一部分.
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segmental dystonia:节段性肌张力障碍
(2)节段性肌张力障碍(segmental dystonia): 累及临近几个部分的肌张力障碍. (3)多灶性肌张力障碍( multifocal dystonia) 累及不相临近多个部位的肌张力障碍. (4)偏侧肌张力障碍(hemidystonia): 指累及同侧的上下肢和躯干的肌张力障碍.
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Chagas' disease (chronic) with heart involvement:慢性查加斯病伴有累及心脏
慢性查加斯病伴有累及消化系 Chagas' disease (chronic) with di... | 慢性查加斯病伴有累及心脏 Chagas' disease (chronic) with heart involvement | 慢性查加斯病伴有累及神经系统 Chagas' disease (chronic) with...
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Acute Chagas' disease with heart involvement:急性查加斯病伴友累及心脏
柯萨奇病毒引起的急性支气管炎 Acute bronchitis due to stre... | 呼吸道合胞病毒引起的急性(毛细支气管炎)细支气管炎 Acute bronchitis ... | 急性查加斯病伴友累及心脏 Acute Chagas' disease with heart involvement
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Chagas' disease (chronic) with digestive system involvement:慢性查加斯病伴有累及消化系
未特指的绦虫感染 Cestode infection unspeci... | 慢性查加斯病伴有累及消化系 Chagas' disease (chronic) with digestive system involvement | 慢性查加斯病伴有累及心脏 Chagas' disease (chronic) with heart in...
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Chagas' disease (chronic) with other organ involvement:慢性查加斯病伴有累及其他器官
慢性查加斯病伴有累及神经系统 Chagas' disease (chronic) with nervous system involvement | 慢性查加斯病伴有累及其他器官 Chagas' disease (chronic) with other organ involvement | 无牙症 Chalazion