重症胰腺炎合并ARDS的诊断治疗

目的探讨重症胰腺炎（SAP）并发成人呼吸窘迫综合症（ARDS）的诊断和治疗。方法对我院近10年收治的72例重症胰腺炎（SAP）其中并发成人呼吸窘迫综合症38例进行回顾性临床总结，分析其血气PaO2／FiO2、Qs／Qt等与诊断和治疗的关系。结果重症胰腺炎（SAP）并发ARDS的发生率52．77％（38／72）．在及时合理治疗原发病的基础上，均给予机械通气，平均6．5天，机械通气24h后血气分析显示PaO2为（94．85±12．25）mmHg，PaO2为（34．4±7．05）mmHg，Qs／Qt值为5．25％±6．85％，全组死亡10例，放弃治疗3例，死亡率26．31％。结论重症胰腺炎（SAP）在及时处理原发病的基础上，对并发的ARDS进行早期诊断和治疗，正确使用呼吸机，防治并及时处理其它并发症，是降低病死率的有效措施。

Study of diagnosis and treatment of acute respiratory distress syndrome (ARDS) caused by severe acute pancreastitis

Objective To study the diagnosis and the treatment of acute respiratory distress syndrome（ARDS） caused by severe acute pancreatitis. Methods The date of 38 cases with ARDS caused by SPA and the rdationship of their PaO2/FiO2, and Qs/Qt between the diagnosis and the treatment of ARDS was analyzed. Results All 38 cases were given mechanical ventilation, Average time of mechanical ventilation was 6.5 days. Blood gas of 24 hours behind mechanical ventilation analysis showed ： PaO2 （94. 85 ± 12.25 ） mmHg, PaCO2 （34.4 ± 7.05 ） mmHg, Qs/Qt 5.25 % ± 6.85 %. 3 cases （ 11.1%, 3 of 36 ） died. Conclusion To reduce the deathof ARDS, We should diagnose and treat ARDS as early possible and use mechanical ventilation trentment correctly and terat complication in time.