胸外伤致急性呼吸窘迫综合征36例临床分析

36 cases of acute respiratory distress syndromwe caused by chest injury

目的 探讨胸外伤致急性呼吸窘迫综合征 (ARDS)的诊断和治疗。方法 对 36例严重胸外伤并发急性呼吸窘迫综合征病人进行回顾性临床总结 ,分析其血气PaO2 /FiO2 、Qs/Qt等与诊断及治疗的关系。结果 本组病人ARDS占同期胸外伤 (5 0 0例 )的 13 9%。早期血气分析显示PaO2 为 6 5 8± 0 96kPa,Pa CO2 为 4 5 4± 1 0 7kPa ,Qs/Qt为 2 4 83%± 8 75 % ,PaO2 /FiO2 为 11 99± 2 93kPa ,36例均给予机械通气 ,平均 7 2d。全组死亡 5例 ,死亡率约 13%。治愈者平均住院 2 9 6d。结论 早期诊断和治疗ARDS ,正确使用呼吸机治疗并及时处理并发伤和休克是降低本病死亡率的最有效措施。同时早期处理并发症和合理应用抗生素也相当重要。

Objective To study the diagnosis and the treatment of acute respiratory distress syndrome(ARDS) caused by chest injury.Methods The data of 36 cases with ARDS caused by chest injury and the relationship of their PaO 2/FiO 2 and Qs/Qt between the diagnosis and the treatment of ARDS was analyzed.Results Early blood gas analysis showed:PaO 2 6.58±0.96kPa,PaCO 2 4.54±1.07kPa,Qs/Qt 24.83%±8.75%,PaO 2/FiO 2 11.99±2.93kPa.All 36 cases were given mechanical ventilation.Average time of the mechanical ventilation was 7.2 days.5 cases(13%,5 of 36) died.Conclusion To reduce the death rate of ARDS.We should diagnose and treat ARDS as early possible and use mechanical ventilation treatment correctly and treat complications in time.