重症闭合性胸外伤呼吸功能不全因素分析及治疗

Analysis of etiology and therapeutics in lung insufficience following severe closed chest injury

目的:分析重症闭合性胸外伤呼吸功能不全病因,总结治疗经验。方法:对36例重症闭合性胸外伤致呼吸功能不全患者进行回顾性研究,总结其造成原因及治疗经验。结果:本组36例呼吸功能不全占同期闭合性胸外伤24%,治愈35例,死亡1例,死于急性呼吸窘迫综合征(ARDS),病死率2.9%。结论:重症闭合性胸外伤中呼吸功能不全主要由浮动胸壁及肺挫伤等引起,肺挫伤的治疗主要是针对ARDS的预防和治疗,对ARDS应及时应用以呼吸器PEEP模式治疗为主的综合治疗。

Objective To analyse the etiology in lung insufficience following severe closed chest injury and sum up the experience of therapeutics. Methods 36 patients with lung insufficience following severe closed chest injury were investigated. Results 36 cases occur lung insufficience （24%）, 1 case died of ARDS. Conclusion The main etiology of lung insufficience following severe closed chest injury was lung contuse. The therapeutics of lung contuse were directed against prevention and management of ARDS. The mechanical ventilation with PEEP mode was primary treatment for the patient with ARDS.