重症胸外伤导致急性呼吸窘迫综合征临床研究.docVIP

重症胸外伤导致急性呼吸窘迫综合征临床研究 　　[摘要] 目的 探讨严重胸外伤致急性呼吸窘迫综合征（ARDS）的诊疗方法。 方法 对我院2007年7月～2015年2月期间治疗的89例严重胸部外伤患者中的21例严重胸部外伤合并急性呼吸窘迫综合征（ARDS）患者的诊断、治疗进行分析和总结。通过比较治疗前后的氧分压（PaO2）、二氧化碳分压（PaCO2）、氧合指数（PaO2/FiO2），并给予患者保持呼吸道通畅，通过比较患者生命体征的变化情况，评估治疗效果。 结果 经治疗后，患者的PaO2明显升高，PaCO2明显下降，PaO2/FiO2明显升高，与治疗前对比，差异有统计学意义（P0.05）；21例患者中有6例出现并发肺炎，对症治疗后痊愈，其中2例死亡，1例因为失血过多，另外1例主动放弃治疗。 结论 早期发现并且早期给予治疗ARDS对预后具有重要意义，在治疗过程中，合理正确使用呼吸机是提高治疗成功率最有效的措施。 　　[关键词] 重症胸外伤；急性呼吸窘迫综合征；氧合指数（PaO2/FiO2） 　　[中图分类号] R563.8 [文献标识码] B [文章编号] 1673-9701（2015）16-0036-03 　　[Abstract] Objective To investigate the diagnosis and treatment method of acute respiratory distress syndrome （ARDS） caused by severe chest traumain. Methods Complicated 89 cases in our hospital from July 2007 to February 2015 with severe chest trauma in patients， among which 21 cases with acute respiratory distress syndrome （ARDS）， the diagnosis， treatment were analyzed and summarized. Through the comparison of oxygen partial pressure （PaO2）， partial pressure of carbon dioxide （PaCO2）， oxygen index （PaO2/FiO2） before and after treatment， and were given thepatients to maintain respiratory tract unobstructed， through compared the change patient vital signs to value treatment effect evaluation. Results After treatment， PaO2 increased， PaCO2 decreased， PaO2/FiO2 increased significantly， there were significant differences compared with those before the treatment （P0.05）； in 21 cases， 6 cases were complicated with pneumonia appears， and they were recovered after symptomatic treatment； of which 2 cases died， 1 case of death due to excessive blood loss， also 1 case gave up the treatment. Conclusion Early detection and early treatment of ARDS is significant prognostic， in the course of treatment， reasonable and correct use of breathing machine is effect measure to improve the success rate of treatment. 　　[Key words] Severe thoracic trauma； Acute respiratory distress syndrome； Oxygen index （PaO2/FiO2） 　　随着交通和工业社会的发展，导致胸部创伤越来越严重和复杂。胸部创伤的病例数明显增加，严重的创伤、病情复杂，常合并多发伤是目前胸外伤的