严重肺挫伤合并急性呼吸窘迫综合征的诊治

Deiagosis and treatment on the severe pulmonary contusion associated with ARDS

目的 提高对严重肺挫伤合并急性呼吸窘迫综合征(ARDS)的认识。方法 对24例严重肺挫伤合并ARDS患者的临床资料进行回顾性分析。结果本组患者ARDS占同期外科ICU严重肺挫伤患者(47例)的51.1％,全组死亡6例,死亡率25％,24例均给予机械通气;并发肺炎占12例,感染率50％。结论 救治严重肺挫伤合并ARDS患者的关键在于对导致ARDS的原发病肺挫伤有充分认识。早期诊断和治疗,正确使用呼吸机,正确治疗多发性损伤是减少ARDS死亡率的有效方法。

Objective To improve to recognition of severe pulmonary contusion complicated by acute respiratory distress syndrome. Methods 24 patients with severe pulmonary contusion complicated by ARDS were analyzed retrospectively. Results In this group, ARDS accounted for 51. 1 % in the severe pulmonary contusion of ICU (24/47). The mechnical ventilation was necessary in all patients. The morbidity of pulmonary infection was 50% . 6 patients died, the mortality rate was 25%. Conclusion The key of rescue is to enough recognition of severe pulmonary contusion for inducing ARDS. Early diagnosis and treatment, correct application of mechanical ventilation and correct treatmant of mutiple injuries are effective methods to decrease mortality of ARDS.