肺挫伤致急性呼吸窘迫综合征临床分析

目的　探讨肺挫伤致ARDS相关危险因素。方法　总结 1 2 6例肺挫伤的临床资料 ,并将住院时间 >2 4小时的 1 1 0例分为ARDS组和非ARDS组 ,对其致伤原因、伤情及治疗结果进行对比分析。结果　本组ARDS发生率 30 .2 % ,肺挫伤并严重多发伤ARDS发生率较单纯肺挫伤高 (P <0 .0 1 )。交通伤为肺挫伤最主要原因 ,ARDS组挤压伤多 ,坠落伤较少 (P <0 .0 1 ) ;ARDS组损伤严重 (ISS >2 5 ) ,ISS评分明显高于非ARDS组 (P <0 .0 1 ) ,其浮动胸壁、休克、多发伤发生率明显高于非ARDS组 (P <0 .0 1 )。结论　合并严重多发伤 (ISS >2 5 )、浮动胸壁、休克等是肺挫伤致ARDS重要危险因素 ,应针对其进行早期有效治疗

Clinical analysis of acute respiratory distress syndrome caused by pulmonary contusion

Objective To analyse the risk factors correlated with acute respiratory distress syndrome (ARDS) caused by pulmonary contusion.?Methods Clinical data of 110 cases in 126 patients with pulmonary contusion staying more than 24 hours in the hospital were divided into ARDS and without ARDS groups.?The cause of trauma,injury characteristics and results of treatment were compared retrospectively.?Results Morbidity of ARDS after pulmonary contusion was 30.2% which was higher in patients with severe multiple injury than that in single pulmonary contusion(P<0.01).?The traffic injury was common in both groups,and ARDS group with higher frequency crush injury and lower in fall injury(P<0.01).?The injury degree of ARDS group was severe (ISS>) in which ISS,the morbidity of flail chest,shock and multiple injury were higher than that without ARDS group(P<0.01).?Conclusion The risk factors of ARDS after pulmonary contusion are severe multiple injuries(ISS>25),flail chest and shock.?The early effective treatment for these factors are very important.