胸部创伤并发急性呼吸窘迫综合征的治疗

目的：总结胸部创伤并发急性呼吸窘迫综合征（ARDS）的临床特点。方法：对22例胸部创伤并发ARDS的患者进行分析；其中，肺叶切除术后6例，食管贲门癌术后10例，胸部严重外伤6例。救治方法主要包括去除病因，给予呼吸支持及循环支持等。结果：抢救成功18例，死亡4例。死亡原因主要是多器官功能衰竭及严重的肺部感染。结论：ARDS确诊后，应尽早应用机械通气治疗，其中包括使用呼气未正压通气、间歇正压通气等方法。

The treatment of acute respiratory distress syndrome follo wing thoracic injuries

Objective:To summarize the clinical charcteristics of the acute respiratory distress syndrome(ARDS) following thoracic injuries.Methods:Twenty two cases of ARDS following thoracic injuries were analyzed,among them 6 cases had undergone pneumo lobectomy,10 cases resection of the esophagus and gastric cardia and 6 cases had severe thoracic inyuries.The therapy consisted of removing of the causes of disease and supporting of the respiration and circulation.Results:Eighteen patients recovered,4 patients died.The causes of deaths were multiple organ failure and severe pulmonary inflammation.Conclusions:Once diagnosed,the mechanical ventilation(MV) should be performed as early as possible,which consists of the positive and expiratory pressure(PEEP) and intermittent positive pressure ventilation(IPPV).