重症胸外伤合并呼吸窘迫综合征的诊疗方法.pdfVIP

Medical Information Section of Operative Surgery．Oct．2007 — — ． Vo1．20．N0．10 重症胸外伤合并呼吸窘迫综合征的诊疗方法 鲁春贤 (驻马店市中心医院胸科，河南驻马店463000) 摘要：目的 探讨重症胸外伤并发呼吸窘迫综合征的诊疗方法。方法 对19例重症胸外伤合并急性呼吸 窘迫综合征患者采用机械通气治疗，比较治疗前后PaO 、PaCO 、PaO ／FiO ，并给予患者保持呼吸道通畅，检 测患者生命征的变化。结果 所有患者除3例死于颅内再出血和多脏器功能衰竭外，其余均治愈出院。结论 呼吸窘迫综合征一经确诊，应积极进行早期有效治疗，同时改善低氧血症是治疗呼吸窘迫综合征成功的关 键。 ． 关键词：重症胸外伤；呼吸窘迫综合征；诊疗 中图分类号：R655 文献标志码：A 文章编号：1006—1959(2007l 10—0896—02 Diagnosis and treatment of respiratory distress syndrome(RDS)from severe thoracic i ury LU Chun—xian (Department of Thoracic Surgery，the Central Hospital of Zhumadian city，Zhumadian 463000，Henan Province，China) Abstract：Objecfive To investigate the diagnosis and treatment of severe thoracic injury from RDS．Methods Ninteen pafien~with severe RDS from chest trauma were given mechanical ventilation，and the PaO2，PaCO2，PaO2／ FiO2 were compared preoperatively and postoperatively；the changes of vital signs were detected，keeping the respiratory tract unobstructed．Results AU the patients were cured and left hospita1．but three case were dead for rebleeding and multiple organ failures．Conclusions Once the diagnosis of RDS is made，pelvic abscess must be given effectively in the early stage，and the improvement of hypoxemia is key to the treatment of RDS． Key words：severe thoracic injury；RDS；diagnosis and treatment 重症胸外伤是诱发急性呼吸窘迫综合征(respira— 血气胸13例，休克5例，纵隔气肿3例，肺挫伤2例， tory distress syndrome，RDS)的重要危险因素之一…， 膈肌破裂合并内脏破裂2例。x线胸片示伤侧肺野内 其所致急性呼吸窘迫综合征(acute respiratory distress 均见大小不等的云絮状斑片阴影。合并颅脑伤9例， syndrome，ARDS)也是导致患者死亡的重要原因 』。 其中5例昏迷。合并其他骨折8例。 回顾性分析