老年人呼吸窘迫综合征的诊治问题（附14例临床分析）  

Clinical experience on the diagnosis and therapy of ARDS:an analysis of 14 cases

作　　者：牟小芬[1] 张进川[1] 刘长庭[1] 何连德[1] 

机构地区：[1]北京市解放军总医院

出　　处：《中华老年医学杂志》1995年第2期92-94,共3页Chinese Journal of Geriatrics

摘　　要：报道１４例老年人因患肺炎、心肌梗塞、肠梗阻术后等病引起的呼吸窘迫综合征（ＡＲＤＳ）。有活者２例，死亡１２例，其中１０例有病理检查。病理所见均有肺实变，肺泡透明膜形成。痰细菌培养主要为绿脓杆菌、克雷白杆菌等革兰阴性菌。ＡＲＤＳ与老年人肺部感染、冠心病、肺水肿关系密切。相互影响。通过病例分析提出早期诊断的要点。治疗关键是纠正基础疾病和严重的低氧血症，有效的抗炎，机械通气加呼气末正压。体外膜肺和激素在治疗上有一定作用。Abstract Fourteen elderly patients of ARDS were admitted into our hospital from 1981 to 1993. The initiating causes included pneumonia, myocardial infarction, abdominal operation etc. Two of them survived and twelve died. Autopsy was performed in 10 cases. Lung consolidation and alveolar hyalinosis were present in all of them. Gram-negative bacteria such as pseudomonas aeruginosa and Klebsiella pneumoniae were found in the cultures of sputum. The interrelation between ARDS and coronary artery disease was noticed and the distinction between ARDS and cardiogenic pulmonary edema was stressed. The relation between infection and ARDS was also discussed. It is imperative to relieve hypoxemia as soon as possible. Ventilator with PEEP, hormone therapy and extracorporeal membrane oxygenator were of benifit to the Patients.

关 键 词：呼吸窘迫综合征 病因学 病理学 老年人 

分 类 号：R563.802[医药卫生—呼吸系统]