A new combined therapy to 15 patients with multiple organ failure in abdominal surgery

摘要

AIMS We report 15 cases of abdominal-surgical multiple organ failure(MOF) treated successfully by a new combined therapy four high doses in volume and one support "FHDOS" short period high doses in large volume anisodaminum; short period high doses in large volume dexamethasonum; high doses in large volume of disinfectant antibiotics; high doses in large volume of abdominal cavity washing liquor and support of nutrition metabolism. The mortality rate and cost of MOF were decreased. It is simple, practical and effective. METHODS The study group consisted of 15 patients (10 women , 5 men ; average age, 42.7) who were hospitalized in our hospital. All patients were given "FHDOS": short period high in large volume Anisodaminum: intravenous injection 40 mg once; another 40mg may be added 30 minutes later according to condition. The total amount may reach 120-240 mg a day, or, intravenous injection 40 mg every 15 minutes until condition being under control. Short period high doses in large volume Dexamethasonum: intravenous injection 100-200 mg once; this remedy may be continued for 1-3 days; the amount also may decrease according to condition. High doses in large volume of dis-infectant Antibiotics: select and use antibiotics according to clini-cal condition, inference of Gram's stain; it is necessary to repeatedly culture bacteria in many parts, and then, to make adjustment according to culture result and drug-resistance, and to prevent carefully the dual infections from occurring. High doses in large volume of abdominal cavity washing liquor: generally adopting physiological saline 6000-8000ml in washing abdominal cavity. "One support" means full support of nutrition metabolism. RESULTS All the patients in this group survive well after the rescue without any complication. CONCLUSIONS MOF should be prevented, if possible, by stopping or controlling the injury, removing as much necrotic tissue as possible, improving blood flow and oxygen consumption, supporting metabolism, and preventing infection or treating it early and adequately. "FHDOS" is a combined therapy and plays a key role in treating MOF.