急性氨气吸入性肺损伤32例临床诊治分析  

The clinical diagnosis and treatment of acute lung injury induced by ammonia inhalation for 32 cases

作　　者：赵凤德[1] 韩明峰[1] 孙伟[1] 冉献贵[1] 

机构地区：[1]安徽省阜阳市第二人民医院呼吸科,236015

出　　处：《蚌埠医学院学报》2012年第4期412-414,共3页Journal of Bengbu Medical College

摘　　要：目的:探讨急性氨气吸入性肺损伤的临床特点、规范化诊断与治疗措施,为该病的病情评估、预后估计及疾病随访提供帮助。方法:对32例急性氨气吸入性肺损伤患者均给予氧气吸入,保持呼吸道通畅,喉梗阻窒息3例急诊气管切开。急性期采用糖皮质激素治疗,预防感染,加强营养支持及对症治疗。结果:32例均救治成功,随访6个月,8例并发轻微肺间质纤维化。结论:急性氨气吸入性肺损伤患者的病情评估和预后估计应参考支气管镜检查结果。早期糖皮质激素应用、预防继发感染、充分雾化促进排痰和适时气管切开保持呼吸道通畅是保证治疗成功的关键。Objective：To explore the clinical features,diagnosis and treatment of acute lung injury induced by ammonia inhalation for providing the help of disease assessment,prognosis and follow-up.Methods：Thirty-two cases with acute lung injury induced by ammonia inhalation were treated with oxygen inhalation and keeping the unobstructed of respiratory tract.Three cases with laryngeal obstruction were tracheotomied.In acute stage,glucocorticoid,prevention of infection,nutrition support and symptomatic treatment were applied.Results：Thirty-two cases were treated successfully.Eight cases appeared slight pulmonary fibrosis after 6 months of follow-up.Conclusions：The results of the bronchoscopy are important for disease assessment and prognosis of acute lung injury induced by ammonia inhalation.The early application of corticosteroids,preventing secondary infection,the full atomization to promote expectoration and timely tracheostomy to maintain airway patency are the keys to ensure successful treatment.

关 键 词：气体中毒 氨气 肺损伤 急性呼吸窘迫综合征 机械通气 

分 类 号：R595.1[医药卫生—内科学]