多发伤合并肺挫伤致急性呼吸窘迫综合症的治疗体会

外科研究与新技术 ›› 2012, Vol. 1 ›› Issue (1): 66-68.

多发伤合并肺挫伤致急性呼吸窘迫综合症的治疗体会

张磊, 赵叶娜, 张泓, 钱振宇

上海同济大学附属同济医院ICU,上海 200065

出版日期:2012-09-28 发布日期:2012-01-25

Treatment of ARDS caused by multiple injuries with pulmonary contusion

Zhang Lei, Zhao Ye-Na, Zhang Hong, Qian Zhen-Yu

Department of ICU,Tongji Hospital Affiliated to Tongji University,Shanghai 200065,China

Online:2012-09-28 Published:2012-01-25

摘要/Abstract

摘要： 目的提高诊治肺挫伤致急性呼吸窘迫综合症(ARDS)的认识。方法对18例肺挫伤致急性呼吸窘迫综合症患者的临床情况进行回顾性分析, 采用SIMV+PSV+PEEP模式行机械通气。观察通气前后SpO₂、血气分析、生命体征及临床症状的变化。结果机械通气后PaO₂、PaCO₂、PaO₂/FiO₂及HR值较通气前明显改善, 有统计学意义(P<0.01), SpO₂高于通气前(P<0.05)。本组治愈15例, 死亡3例, 发生肺部感染8例。结论适当的PEEP应用机械通气是救治肺挫伤合并ARDS的有效的方法。

关键词: 肺挫伤, 多发伤, ARDS

Abstract: Objective To enhance the clinical understanding of the diagnosis and treatment of acute respiratory distress syndrome (ARDS) caused by severe pulmonary contusion in multiple trauma patients.Method 18 cases of severe pulmonary contusion complicated with ARDS were retrospectively reviewed.All the patients underwent mechanical ventilation with SIMV+PSV+PEEP mode and clinical data such as SpO₂,PaO₂,PaCO₂,PaO₂/FiO₂ and vital signs were collected and analyzed.Result Of them,18 cases of severe pulmonary contusion,15 were fully recovered and 3 died; pulmonary infection was seen in 8 cases.Our data showed a significantly improvement of patients’ clinical status after initiation of the mechanical ventilation,with increased PaO₂,PaCO₂,PaO₂/FiO₂ (P<0.01) and SpO₂ (P<0.05) and reduced HR (P<0.01).Conclusion Mechanical ventilation with appropriate PEEP is an effective therapeutic method for severe pulmonary contusion complicated with ARDS.

Key words: Pulmonary contusion, Multiple injuries, ARDS

中图分类号:

R655.3

张磊, 赵叶娜, 张泓, 钱振宇. 多发伤合并肺挫伤致急性呼吸窘迫综合症的治疗体会[J]. 外科研究与新技术, 2012, 1(1): 66-68.

Zhang Lei, Zhao Ye-Na, Zhang Hong, Qian Zhen-Yu. Treatment of ARDS caused by multiple injuries with pulmonary contusion[J]. 外科研究与新技术, 2012, 1(1): 66-68.