Buchman T G
Johns Hopkins University School of Medicine, Department of Surgery, Baltimore, MD 21287-5612, USA.
Curr Opin Gen Surg. 1993:26-31.
Multiple organ failure remains a leading cause of death in surgical intensive care units. This review of multiple organ failure focuses on recent (1990 to 1992) laboratory and clinical advances related to diagnosis, prognosis, and therapy of multiple organ failure and is divided into three parts. First, it recasts multiple organ failure into the currently accepted terminology, ie, the multiple organ dysfunction syndrome. Second, it examines the strengths and weaknesses of three mechanistic hypotheses proposed for the clinical syndrome. The three hypotheses focus on the gut, molecular mediators, and the microvasculature. Third, it synthesizes those three mechanisms into a single paradigm; this unifying paradigm can serve as a framework in which to interpret subsequent laboratory and clinical advances.
多器官功能衰竭仍然是外科重症监护病房患者死亡的主要原因。本综述聚焦于多器官功能衰竭（涵盖1990年至1992年期间）在诊断、预后及治疗方面的最新实验室研究成果和临床进展，并分为三个部分。首先，将多器官功能衰竭重新归类为当前公认的术语，即多器官功能障碍综合征。其次，审视针对该临床综合征提出的三种机制假说的优缺点。这三种假说分别聚焦于肠道、分子介质和微血管系统。第三，将这三种机制整合为一个统一的范式；这个统一范式可作为一个框架，用于解读后续的实验室研究成果和临床进展。
