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目的研究分析肺挫伤急性呼吸窘迫综合症患者肺循环变化的急救。方法选择我院从2010年10月～2011年10月收治的20例肺挫伤致急性呼吸窘迫综合症患者,将其作为观察组。再另外选取同期收治的无肺挫伤并且没有ARDS多发伤患者20例,将其作为对照组。观察对比两组患者在置管即刻以及伤后不同时间段的肺动脉收缩压、肺动脉舒张压以及肺动脉楔压等指数。结果肺挫伤所导致ARDS存活患者的肺动脉收缩压、肺动脉舒张压以及肺动脉楔压梯度明显高于对照组,随后逐渐回落,两组之间的差异具有统计学意义,P<0.05。观察组中患者的肺动脉楔压在最初明显低于对照组,在伤后的48h后恢复到正常水平,而在随后的时间内再次降低。结论在治疗急性呼吸窘迫综合症时可以将肺动脉收缩压、肺动脉舒张压以及肺动脉楔压等指数的变化作为指导液体治疗以及对病情的评估和分析。
Objective To study the first aid in the analysis of pulmonary circulation changes in patients with acute respiratory distress syndrome after pulmonary contusion. Methods Twenty patients with acute respiratory distress syndrome caused by pulmonary contusion were selected from October 2010 to October 2011 in our hospital as observation group. In addition to select the same period were treated without pulmonary contusion and 20 cases of multiple trauma patients without ARDS, as a control group. The indexes of pulmonary artery systolic pressure, pulmonary artery diastolic pressure and pulmonary artery wedge pressure were observed and compared between the two groups immediately after catheterization and at different time points after injury. Results Pulmonary artery systolic pressure, pulmonary artery diastolic pressure and pulmonary artery wedge pressure gradient in patients with ARDS were significantly higher than those in control group, and then gradually decreased. The difference between the two groups was statistically significant (P <0.05). In the observation group, pulmonary arterial wedge pressure was initially significantly lower than that of the control group, returned to normal levels 48 hours after injury, and decreased again in the following period. Conclusions The changes of pulmonary artery systolic pressure, pulmonary diastolic pressure and pulmonary artery wedge pressure can be used as guide liquid therapy and assessment and analysis of the disease in the treatment of acute respiratory distress syndrome.