严重创伤并发急性呼吸窘迫综合征的治疗对策（附36例报道）

目的探讨严重创伤合并ARDS的治疗方案。方法回顾分析36例严重创伤并发ARDS的诊治过程。结果本组并发肺不张12例（33．3％），气管切开18例，支气管镜吸痰加抗生素灌洗6例，全组因颅内再出血和多脏器功能衰竭死亡7例，自动出院死亡2例，病死率25％。其余均治愈出院。结论严重创伤合并ARDS的治疗重在早期诊断、早期使用呼吸机治疗，采用肺保护性通气策略并及时处理多发伤和休克是降低死亡率的有效措施。

Treatment for Severe Trauma Complicated by Acute Respiratory Distress Syndrome(A Report of 36 Cases)

Objective To discuss the therapeutic strategies of severe trauma complicated by acute respiratory distress syndrome. Methods 36 cases of severe trauma complicated by ARDS were reviewed. Results There were atelectasis 12 cases（33.3% ）, tracheotomy 18 cases, sputum aspiration through bronchoscope and antibiotics lavage 6 cases, 7 cases death for intracranial hemorrhage again and more organ failure, 2 cases death for leaving hospital, the mortality rate was 25 %, the others recovery. Conclusion The therapeutic strategies of severe trauma compli- cated by acute respiratory distress syndrome＇s focal point was early diagnosis, early use life-support machine, use the pulmonary protective ventilation and treating multiple trauma and shock can reduce mortality rate.