开胸术后急性呼吸窘迫综合征的诊治分析

目的 探讨对开胸术后并发急性呼吸窘迫综合征（ARDS）的预防及治疗对策。方法 回顾分析2000-01～2006-0626例开胸术后ARDS患者的病例资料。结果 开胸术后ARDS绝大多数在术后72h内发病（88．46％），所有患者均行呼吸机辅助呼吸，行气管切开23例，并发肺部感染21例、多器官功能不全综合征（MODS）14例。经抢救痊愈18例，死亡8例（死亡率30．78％）。死亡原因为MODS6例，呼吸衰竭合并严重的混合性肺部感染2例。结论 开胸术后患者发生ARDS的原因复杂，加强对开胸术后ARDS的预防，采取准确措施早期积极治疗有望提高抢救成功率。

Treatment of acute respiratory distress syndrome after thoracotomy

Objective To find out the method to prevent and treat the acute respiratory distress syndrome(ARDS)after thoracotomy.Methods Data of 26 patients with ARDS after thoracotomy in our department from January 2000 to June 2006 were retrospectively analysed.Result ARDS was mostly happened within 72 hours after thoracotomy,all the patients with ARDS were treated with mechanical ventilation,23 accepted tracheotomy;21 had complication of pulmonary infection,and 14 had multiple organ dysfunction syndrome(MODS).Out of 26 patients,18 were cured,8 died(30.78%).Conclusion The reason of ARDS after thoracotomy was complex.Accurate measures and active treatment in the earlier period should increase successful rate in the patients with ARDS after thoracotomy.