严重脑损伤合并胸外伤致急性呼吸窘迫综合征48例分析.pdfVIP

现代医院2ωq 年5 月第7 卷第5 期 Modem Hospital May 2ω7 Vol7 No5 16 严嚣脑损伤合并胸外伤致急性呼吸窘迫综合征48 例 分析 胡浩荣苏仁芳李少明曾隆平文艳梅 丁HERAPEUTIC ANALYSIS OF SEVERE CEREBRAL INJURY COMP LlCATED BY THORACIC INJURY WITH ARDS IN 48 CASES HU H.αor07啊， SU ReT庐ng ,LI Shαoming ,et al {摘 要] 目的探讨严重脑损伤合并胸外伤致，急性呼吸窘迫综合征(ARDS) 的有效治疗方法。方法 回顾性分析48 例严重脑损伤合并胸外伤致ARDS 的临床资料。结果 48 例脑损伤均属中、重型颅脑损伤，均 合并肺挫伤、肋骨骨折或/和血气胸而致 ARDS ，行脱水、合理补充血容量、及时机械l!气1t急诊外科手术抢救 治疗。 临床治愈39 例，死亡9 例(死亡率20% )。结论 平期诊断，及时处理脑、胸lf-发伤，尽早正确采用机 械通气是治疗严重脑损伤合并胸外伤致ARDS 的关键，是降低死亡卒的有效措施。 {关键词] 严重脑损伤胸部外伤 急性呼吸窘迫综合私机械通气 [ Abstract] Objective To 叫lore the valid therapeutic me由呻 for 阳的阳咖al inj町 complicated by thoracic injury with ARDS. Metbod First 甲 aid therapeutics and curative efIect of 48 patients with sever咆 cerebral inj町complicated by thoracic injury with ARDS were studied retrospectively. Result The í时urious d咿ees of all patients were medium - heavy cerebral injury complicated by contusion of lung , fracture of rib or/and hemopneumo嗣 thor，似 wi出 ARDS. All the patients were treated with dehydration , rational supplement of blood - volume , betimes- mechanical ventilation and peremptorily surge巧. There were 39 patients who survived , and 9 ones who died (the mortality wω20% ). Conclusion Early diagnoses , betimes treating with the primary injuries of brain and chest , correctly mechanical ventilation are effective methods to treat and to decrease mortality of such sicknesses. [Key words] Severe c咽呻ral inju巧， Thoracic i时町， Acute respiratory 伽饷S8 syndrome; Mechanic且1 venti- lation [A础。rs address] Changping Hospital of Dongguan , Don部u阻， Guangdong Province 523573翩 PRC 随着现代交通业的迅猛发展及建筑业的兴旺，交通事故 4 例。本组米包括外伤直接损伤脑干、脑甜形成引起中枢性 及工伤事故等因素所引起脑、胸部多发伤的发生率是上升跑 呼吸衰塌的病例。其中合并肺挫伤40 例，且在侧胁骨骨折27 势，其中严重脑损伤合并胸外伤敖急性呼吸窘迫综合