创伤致ARDS患者肺部循环异常的急救方法及临床效果观察  

Observation of emergency treatment and clinical effects of ARDS patients with pulmonary circulation anomaly induced by traumatic

作　　者：徐洋 高晶 孙兆瑞 黄昌保 林金锋 邵旦兵 刘红梅 唐文杰 聂时南 

机构地区：[1]南京军区南京总医院(南京大学医学院附属金陵医院)急救医学科,南京210002

出　　处：《临床急诊杂志》2014年第12期725-727,共3页Journal of Clinical Emergency

基　　金：南京军区重点课题(No:12Z32);南京军区南京总医院青年基金课题(No:2013023;2014004)

摘　　要：目的:探讨创伤原因导致的急性呼吸窘迫综合征(ARDS)患者肺部循环异常的急救方法及临床效果。方法:总结我院收治的30例创伤致肺损伤同时伴ARDS患者(观察组)的临床资料和同期30例创伤致肺损伤但不伴有ARDS患者(对照组)的临床资料。根据患者病情行气管插管、机械通气、营养支持方法进行治疗,并比较其组间差异性。结果:观察组在置管前PAD数据均值为(31.1±5.0)mmHg(1mmHg=0.133kPa),治疗12h后均值为(22.5±4.8)mmHg,治疗24h后均值为(17.9±4.2)mmHg,均明显高于对照组(P<0.05)。2组患者治疗36h后PAD、PAS和血管外肺水指数比较,差异无统计学意义。结论:创伤原因导致的ARDS患者在置管和机械通气等急救措施的基础上采取静脉营养支持、液体治疗和对症治疗,对于缓解其肺部循环异常状态具有积极的意义。Objective：To investigate the clinical effects of emergency treatment for ARDS patients with pulmonary circulation anomaly induced by trauma.Method：The clinic data in 30 ARDS patients and 30 catheterization common patients without acute lung injury admitted in our hospital was collected simultaneously.Catheterization,mechanical ventilation and nutritional support were used to treat patients in observation group according to the patient＇s condition.The data was counted using statistical methods according to the statistical indexes to compare differences between two groups.Result：PAD data in the observation group before catheterization was（31.1±5）mmHg.The mean data was（22.5±4.8）mmHg after treatment for 12 hours,and the mean data was（17.9±4.2）mmHg after treatment for 24 hours.The data in observation group were significantly higher than that of statistical results in the control group（P〈0.05）.However,there was no significant difference of PAD mean data in two groups[（15±2.7）mmHg VS（14.9±3）mmHg]（P〉0.05）.PAS and extravascular lung water index data also had similar statistical rules.Conclusion：We adopted parenteral nutrition support,liquid treatment and comprehensive symptomatic treatment based on the intubation and mechanical ventilation treatment for traumatic-induced ARDS which is a positive effect to alleviate the pulmonary circulation anomaly.

关 键 词：急性呼吸窘迫综合征 肺动脉舒张压 肺动脉收缩压 血管外肺水指数 疗效 

分 类 号：R563[医药卫生—呼吸系统]