严重脑损伤合并胸外伤致急性呼吸窘迫综合征48例分析

THERAPEUTIC ANALYSIS OF SEVERE CEREBRAL INJURY COMPLICATED BY THORACIC INJURY WITH ARDS IN 48 CASES

目的探讨严重脑损伤合并胸外伤致急性呼吸窘迫综合征(ARDS)的有效治疗方法。方法回顾性分析48例严重脑损伤合并胸外伤致ARDS的临床资料。结果48例脑损伤均属中、重型颅脑损伤,均合并肺挫伤、肋骨骨折或/和血气胸而致ARDS,行脱水、合理补充血容量、及时机械通气及急诊外科手术抢救治疗。临床治愈39例,死亡9例(死亡率20%)。结论早期诊断,及时处理脑、胸原发伤,尽早正确采用机械通气是治疗严重脑损伤合并胸外伤致ARDS的关键,是降低死亡率的有效措施。

Objective To explore the valid therapeutic methods for severe cerebral injury complicated by thoracic injury with ARDS. Method First - aid therapeutics and curative effect of 48 patients with severe cerebral injury complicated by thoracic injury with ARDS were studied retrospectively. Result The injurious degrees of all patients were medium - heavy cerebral injury complicated by contusion of lung, fracture of rib or/and hemopneumothorax with ARDS. All the patients were treated with dehydration, rational supplement of blood - volume, betimes - mechanical ventilation and peremptorily surgery. There were 39 patients who survived, and 9 ones who died （the mortality was 20% ）. Conclusion Early diagnoses, betimes treating with the primary injuries of brain and chest, correctly mechanical ventilation are effective methods to treat and to decrease mortality of such sicknesses.