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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 30例严重胸外伤并急性呼吸窘迫综合征 (ARDS)患者进行回顾性研究 ,分析其血气、PaO2 FiO2 、Qs Qt等与诊断及治疗的关系。 结果 本组患者ARDS占同期胸外伤 (30 6例 )的 9.8% ,占严重胸外伤(730例 )的 41.1%。早期血气分析显示PaO2 为 (6 .5 1± 0 .97)kPa,PaCO2 为 (4.6 4± 1.0 9)kPa ,Qs Qt为 (2 4.72± 8.93) % ,PaO2 FiO2 为 (12 .11± 2 .99)kPa。 30例均给予机械通气 ,平均 6 .8d ,并发肺炎13例。全组死亡 4例 ,死亡率为 13.3%。治愈者平均住院 34 .2d。 结论 早期诊断和治疗ARDS ,正确地使用呼吸机治疗并及时处理多发伤和休克是降低本病死亡率的有效措施。同时 ,早期处理并发症和合理应用抗生素也相当重要。
Objective To investigate the diagnosis and treatment of acute respiratory distress syndrome (ARDS) caused by chest trauma. Methods Thirty patients with severe chest trauma and acute respiratory distress syndrome (ARDS) were retrospectively analyzed. The relationship between blood gas, PaO2 FiO2, Qs Qt and other diagnosis and treatment was analyzed. Results The ARDS of this group accounted for 9.8% of the thoracic injuries (30 6 cases) in the same period and 41.1% of the severe thoracic injuries (730 cases). Early blood gas analysis showed PaO2 was (6.51 ± 0.97) kPa, PaCO2 was (4.6 4 ± 1.09) kPa, Qs Qt was (2.72 ± 8.93)%, PaO2 FiO2 was (12.11 ± 2) 99) kPa. 30 cases were given mechanical ventilation, an average of 6.8d, 13 cases of pneumonia. The whole group died in 4 cases, the mortality rate was 13.3%. The average hospitalized cured 34 .2d. Conclusion Early diagnosis and treatment of ARDS, the correct use of ventilator to treat and timely treatment of multiple injuries and shock is an effective measure to reduce the mortality of this disease. At the same time, early treatment of complications and rational use of antibiotics is also very important.