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1.
自Ashbaugh于1967年首先报道成人呼吸窘迫综合征(adult respiratory distress syndrome,ARDS)以来,人们对此病的认识日趋加深.至上世纪90年代,学者发现此病并非仅限于成人,儿童同样可患此病,因而改名为急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS),但其英文缩写名不变,仍为ARDS.急性肺损伤(ALI)是与ARDS在病因、发病机制、治疗原则等均为相同的一组综合征,因此,本文将ALI与ARDS一起进行介绍.  相似文献   

2.
我院自2002年4月至2005年4月共收治16例急性创伤性成人呼吸窘迫综合征(Acute respiratory distress syndrome,ARDS)病人,现报告如下:[第一段]  相似文献   

3.
急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)是指严重感染、创伤、休克等肺内外疾病后出现的以肺泡毛细血管损伤为主要表现的临床综合征,是急性肺损伤(acute lung injury,ALI)的严重阶段或类型。其临床特征为呼吸频速和窘迫,进行性低氧血症。1972年Ashbaugh提出成人呼吸窘迫综合征的命名。  相似文献   

4.
ARDS流行病学现状   总被引:8,自引:1,他引:7  
急性呼吸窘迫综合征(Acte respiratory distress syndrome,ARDS)以进行呼吸困难和顽固性氧血症为特征的急性呼吸衰竭,1967年由Ashbaugh等首次提出。目前认为,ARDS是全身炎症反应综合征(SIRS)在肺部失控的结果,也是多器官功能障碍综合征(MODS)在肺部的表现,病理上主要表现为肺内急性炎症,广泛的肺泡-毛细血管膜损伤,  相似文献   

5.
重症急性胰腺炎合并急性呼吸窘迫综合征52例临床分析   总被引:1,自引:0,他引:1  
重症急性胰腺炎(severe acute pancreatitis.SAP)所致的全身炎症反应.能够引起多器官功能障碍综合征(multiple organ dysfunction syndrome.MODS).其中急性呼吸窘迫综合征(acute respiratory distress syndrome.ARDS)为最常见的严重并发症之一。也是早期引起病人死亡的重要原因.其病死率超过40%。  相似文献   

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回顾性分析12例颅脑损伤并发成人呼吸窘迫综合征(adult respiratoty distress syndrome,ARDS)患者的临床资料,并结合文献对颅脑损伤并发ARDS的诊断及治疗进行总结.  相似文献   

7.
保护性机械通气治疗重症胸外伤并ARDS 10例   总被引:5,自引:0,他引:5  
1993年1月至2003年6月共收治重症胸外伤并成人呼吸窘迫综合征(adult respiratory distress syndrome,ARDS)23例,其中2000年1月至2003年6月采用保护性机械通气治疗10例,取得了较好的临床效果,报道如下。  相似文献   

8.
刘玲  邱海波 《医学新知杂志》2007,17(5):249-251,260
急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)是以低氧血症为特征的急性呼吸衰竭。纠正低氧血症是ARDS治疗的首要任务,其根  相似文献   

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现在国内外对成人呼吸窘迫综合征(aduet respiratory distress syndroire,ARDS)已有大量报道资料,因新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)发病较少,且病情变化快,病死率高,因此报道较少。现将2例新生儿肺透明膜病(neonatal pulmonary hyaline membrane disease,HMD)病案报告如下:  相似文献   

10.
颅脑外伤并发急性呼吸窘迫综合征11例治疗分析   总被引:1,自引:0,他引:1  
颅脑外伤并发急性呼吸窘迫综合征(adult respiratory distress syndrome,ARDS)因其发病急骤,病情复杂,抢救相当棘手。我科1994年6月-2006年12月抢救该类患者11例,经积极治疗,效果满意。  相似文献   

11.
Phaeochromocytomas are rare catecholamine-producing tumours. Although classically described to present with headache, diaphoresis and palpitations, they also present in unusual ways; hyperamylasaemia is one such rare presentation. We describe a man with an extra-adrenal phaeochromocytoma (paraganglioma) presenting with diaphoresis, abdominal pain and multi-organ failure. He had hyperamylasaemia of 1,087 (normal range [NR] 44-161) U/L, which mimicked acute severe pancreatitis. Serum lipase and radiographic imaging of the pancreas appeared normal, and the serial amylase levels normalised over six days upon stabilisation of his condition. 24-hour urinary metanephrines of 10,406 (NR 400-1,500) nmol/day suggested a catecholamine-secreting tumour, and metaiodobenzylguanine scintigraphy confirmed this. We postulate that amylase (of the salivary isotype) is released by hypoxic tissues when high catecholamine levels cause vasoconstriction and that fluctuating hypotension decreases organ perfusion. This case highlights the need for awareness of rare presentations of phaeochromocytomas and encourages physicians to rethink the diagnosis when investigations are inconsistent.  相似文献   

12.
急性重症胆管炎致急性肺损伤动物模型的制作   总被引:2,自引:0,他引:2  
目的:复制急性重症胆管炎(ACST)引发的急性肺损伤(ALI)的动物模型。方法:通过胆总管远端结扎,近端注入菌液并封闭的方法,造成大鼠ACST后观察肺功能及病理形态改变。结果:实验组PaO2/FiO2下降;肺系数升高,肺含水量增加;光镜可见充血、水肿、粒细胞浸润和透明膜。结论:此模型符合ALI诊断标准及动物模型的考察指标,说明本模型是成功可靠的。  相似文献   

13.
Objective:To study the pathogenesis of acute lung injury in severe acute pancreatitis (SAP). Methods:Rats were sacrificed at 1, 3, 5, 6, 9 and 12 h after establishment of inducing model. Pancreas and lung tissues were obtained for pathological study, microvascular permeability and MPO examination. Gene expressions of TNF-α and ICAM-1 in pancreas and lung tissues were detected by RT-PCR. Results: After inducing SAP model, the injury degree of the pancreas and the lung increased gradually, accompanied with gradually increased MPO activity and microvascular permeability. Gene expressions of TNF-α and ICAM-1 in pancreas rose at 1 h and reached peak at 7 h. Relatively, their gene expressions in the lungs only rose slightly at 1 h and reached peak at 9-12 h gradually. Conclusion:There is an obvious time window between SAP and lung injury, when earlier protection is beneficial to prevent development of acute lung injury.  相似文献   

14.
Fluid therapy for severe acute pancreatitis in acute response stage   总被引:9,自引:0,他引:9  
Background Fluid therapy for severe acute pancreatitis (SAP) should not only resolve deficiency of blood volume, but also prevent fluid sequestration in acute response stage. Up to date, there has not a strategy for fluid therapy dedicated to SAP. So, this study was aimed to investigate the effects of fluid therapy treatment on prognosis of SAP. Methods Seventy-six patients were admitted prospectively according to the criteria within 72 hours of SAP onset. They were randomly assigned to a rapid fluid expansion group (Group I, n=36) and a controlled fluid expansion group (Group II n=-40). Hemodynamic disorders were either quickly (fluid infusion rate was 10-15 ml.kg-1-h-1, Group I) or gradually improved (fluid infusion rate was 5-10 ml-kg1.h-1, Group II) through controlling the rate of fluid infusion. Parameters of fluid expansion, blood lactate concentration were obtained when meeting the criteria for fluid expansion. And APACHE II scores were obtained serially for 72 hours. Rate of mechanical ventilation, incidence of abdominal compartment syndrome (ACS), sepsis, and survival rate were obtained. Results The two groups had statistically different (P 〈0.05) time intervals to meet fluid expansion criteria (Group I, 13.5±6.6 hours; Group II, (24.0±5.4) hours). Blood lactate concentrations were both remarkably lower as compared to the level upon admission (P 〈0.05) and reached the normal level in both groups upon treatment. It was only at day 1 that hematocrit was significantly lower in Group I (35.6%±6.8%) than in Group II (38.5%±5.4%) (P〈0.01). Amount of crystalloid and colloid in group I ((4028±1980)ml and (1336±816)ml) on admission day was more than those of group II ((2472±1871)ml and (970±633)ml). No significant difference was found in the total amount of fluids within four days of admission between the two groups (P〉0.05). Total amount of fluid sequestration within 4 days was higher in Group I ((5378±2751)ml) than in Group II ((4215±1998)ml, P 〈0.05). APACHE II scores were higher in Group I on days 1, 2, and 3 (P〈0.05). Rate of mechanical ventilation was higher in group I (94.4%) than in group II (65%, P〈0.05). The incidences of abdominal compartment syndrome (ACS) and sepsis were significantly lower in Group II (P 〈0.05). Survival rate was remarkably lower in Group I (69.4%) than in Group II (90%, P〈0.05). Conclusions Controlled fluid resuscitation offers better prognosis in patients with severe volume deficit within 72 hours of SAP onset. Chin Med J 2009; 122(2): 169-173  相似文献   

15.
1病例报告 患者,女34岁。因颈部包块20d余,持续性发热半个月,伴头痛,恶心呕吐1d,于2007年3月22日入院。查体:体温39.7℃,脉搏82次/min,呼吸20次/min,血压110/70mmHg。双侧颈部可扪及数枚大小不等的淋巴结,较大约束力2.5cm×1cm,活动尚可,质硬,触压痛明显,心,肺,腹未见异常。血常规:白细胞1.98×10^9L,中性粒细胞0.14,淋巴细胞0.39,单核细胞0.18,嗜酸性料脑脊检查正常。结核抗体和PPD试验均阴性。  相似文献   

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Severe rhabdomyolysis complicated by respiratory and renal failure developed three weeks after initiation of low dose lovastatin therapy in a 79 year old, non-immunocompromised patient. The concomitant use of gemfibrozil may increase the risk of this complication.  相似文献   

20.
Kashyap AS  Anand KP  Kashyap S 《JAMA》2004,292(11):1305; author reply 1305
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