严重多发伤致急性呼吸窘迫综合征救治体会

目的总结严重多发伤致成人急性呼吸窘迫征的救治经验。方法分析2006年6月～2012年4月收治的交通事故致急性呼吸窘迫征病例144例的临床资料。结果本组伤员144例。其中死亡病人28例,死亡率19.44%,死于原发性损伤10例,主要死于失血性休克、广泛的心脏挫伤和肺挫伤。死于继发性损伤18例,主要死于多脏器功能不全和重症感染。结论对于严重多发伤致急性呼吸窘迫征患者,快速有效的院前急救,经验丰富的创伤救治团队是提高救治率的前提。快速诊断,及早进行损伤控制性手术,正确使用呼吸机,积极改善胃肠功能,积极控制原发病是提高治愈率,降低死亡率的关键。

Treatment experience of acute respiratory distress syndrome caused by multiple trauma

Objective To summarize the treatment experience of adults with acute respiratory distress syndrome caused by serious multiple injuries. Methods The clinical data of 144 patients with acute respiratory distress syndrome caused by traffic accidents from June 2006 to April 2012 were retrospectively analyzed. Results 58 cases of death reported and the mortality was 19.44%, which includ- ed 10 cases of primary injury caused by hemorrhagic shock, cardiac contusion, and pulmonary contusion, and 18 cases of secondary injury caused by multiple organ dysfunction and severe infection. Conclusion The premise to improve the curative effect of patients with acute respiratory distress syndrome caused by serious multiple injuries is fast and effective pre-hospital emergency treatment and experienced trauma treatment team. The keys to reduce mortality include rapid diagnosis, early damage control surgery, proper use of the ventilator, improving gastrointestinal function, and control the primary affection.