成人创伤后呼吸窘迫综合征18例临床分析

本文报道18例创伤后成人呼吸迫征(ARDS),男性15例,女性3例,年龄11岁到79岁,5例治愈。本组ARDS的主要病因是严重创伤(10例)、大手术(4例)、烧伤(4例)、休克、感染、DIC、过量输液等。诊断依据为:(1)病史中诱发ARDS的病因;(2)临床急性呼吸衰竭症状;(3)X线胸片“点状”及“雪片状”阴影;(4)低氧血症:(5)血小板减少;(6)尸检肺部病理检查符合ARDS变化。ARDS的预防措施包括有及早预防及治疗,如针对休克、感染的控制,防止过量输液及DIC的早期治疗,特别要注意预防措施,及多器官衰竭的治疗,积极处理肺间质水肿,加压通气保持呼吸道畅通等措施。

ANALYSIS OF 18 CASES WITH POST TRUAMA ARDS

18 cases with the post-trauma ARDS were reported. There were 15 men and 3 women, age from 11 to 79 years, 5 cases were cured.In this group, the causes inducing ARDS mainly were serious trauma (10 cases), operation (4 cases) , burning (4 cases), shock, infection, DIC, over infusion of fluid, etc.The criteria of diagnosis were : Dcauses inducing the ARDS in history; 2) clinical presences of the acute respiratory failure or anoxia; 3) spot or flake shodows in chest x-ray examination; 4) hypoxemia; 5) reduced counts of platelets and 6) pulmonary pothologic changes coinciding with the ARDS changes in autopsy.The preventive measures of the ARDS included the prevention and treatment of shock, the control of infection, the prevention of over-fluid infusion and the early treatment of DIC, and paying attention to the prevention and treatment of multiple organ failures. The treating methods mainly were keeping the respiratory tracts fluent with stressed pressure, actively treating the pulmonary interstitial edema with various measures