急性胆囊炎合并2型糖尿病术后急性呼吸窘迫综合征分析

Postoperative ARDS in the acute cholecystitis combined with type 2 diabetes

目的 :探讨急性胆囊炎合并 2型糖尿病术后发生急性呼吸窘迫综合征 (ARDS)的原因和防治措施。方法 :对本院 1989～ 2 0 0 1年急性胆囊炎合并 2型糖尿病 385例 (A组 )及无合并 2型糖尿病的 2 37例 (B组 )行急诊手术后 ,发生ARDS的患者进行分析。结果 :A组发生 16例ARDS ,B组发生 1例ARDS ,两组差异有显著性 (P <0 .0 1)。结论 :大量输液、内毒素血症、肺部感染是导致ARDS的主要原因。而以适当的方式控制输液量 ,积极合适的手术方式和及时去除感染病灶 ,积极的机械辅助呼吸 ,对急性胆囊炎合并 2型糖尿病术后ARDS的发生和治疗有积极意义。

Objective:To study the cause,prevention and treatment of postoperative acute respiratory distress syndrome(ARDS) in the patients with acute cholecystitis accompanied with type 2 diabetes.Methods:The hospital records of 385 cases with acute cholecystitis and type 2 diabetes(group A) and 237 cases without type 2 diabetes(group B) were reviewed and analyzed.Results:Sixteen cases developed ARDS in group A,while only 1 case in group B was noted to have ARDS.The difference was significant( P <0.01).Conclusions:A great quantity of transfusion,endotoxinemia and pulmonary inflammation are the major causes for ARDS in group A.Proper control of the quantity of transfusion,appropriate operation mode to wipe off infection fault and active mechanically assisted breath might prevent and cure postoperative ARDS in patients with acute cholecystitis combined with type 2 diabetes.