以机械通气为主对胸外伤致ARDS的救治及监测

为探讨胸外伤并发急性呼吸窘迫综合征(ARDS)的救治措施。对我院1983年5月至1998年5月收治的胸外伤并发ARDS 23例进行发生指数(Ⅰ值)分布统计,并回顾性动态观察Ⅰ值的变化与治疗效果的关联性。结果Ⅰ值在胸外伤并发ARDS的救治中起到动态量化监测病情转归及救治方法是否得当的作用。Ⅰ值增高,提示病情好转、治疗有效,反之病情恶化,不良预后。结果提示,以机械通气(MV)为主,兼顾胸部创伤早期处理,合理的抗体克、营养支持,及时纠正酸碱失衡,积极的抗生素及漱素应用等一系列综合救治能有效地降低胸外伤并发ARDS的病死率。

Comprehensive Emergency Treatment and Occurrence Index Monitoring of Acute Respiratory Distress Syndrome Following Thoracic Injury

To explore emergency measures to treat acute respiratory distress syndrome (ARDS) following thoracic injury. Occurrence indexes (I score) of 23 cases of ARDS following thoracic injury in our hospital from May, 1983 to May,1998 were distributively analysed and the relativity between changes of I(?)(?)ores and treatment results were dynamically observed and reviewed. I scores played a role in monitoring prognosis b; dynemie quantization and deciding emergency measures proper or not during the emergency treatment of ARDS following thoracic injury. The increase of I scoremdicated the improvement of patient's condition and effective treatment, whereas indicated exacerbation and poor prognosis. A series of comprehensive treatmenls, such as mechanical ventilation as a main measure with early treatment of thoracic injury, adequate antishock, nutrtional support, remeding acid-base unbalance,active antibiotic,hormone application,et al could effectively reduce fatality rate of ARDS following thoracic injury.