[开胸术后急性呼吸窘迫综合征的致病性与治疗]
[Pathogenicity and treatment of acute respiratory distress syndrome after thoracotomy].
作者信息
Chen Xiao-feng, Ding Jia-an, Gao Wen, Jiang Lei, Sun Guang-ya, Hu Zheng-he
机构信息
Department of Thoracic Surgery, Shanghai Pulmonology Hospital, Shanghai 200433, China.
出版信息
Zhonghua Wai Ke Za Zhi. 2003 Dec;41(12):906-8.
OBJECTIVE
To investigate the causes of acute respiratory distress (ARDS) after thoracotomy and to find out the measures to prevent ARDS.
METHODS
The characteristics of incidence, pathogenicity and treatment of ARDS after thoracotomy in 31 patients were analysed.
RESULTS
The patients who had chronic obstructive pulmonary disease, long history of smoking, hypertension were prone to ARDS. Injury to lung in operation, shock and pulmonary infection probably caused ARDS. Clearing away respiratory tract secretion, preserving of a clear airway, controlling pulmonary infection, alleviating pneumonedema by diuresis, early executing tracheotomy or mechanic assistant ventilation by tracheointubation were keys to rescuing patients successfully.
CONCLUSIONS
It is suggested that multi factors were related to ARDS after thoracotomy. Shock, injury to lung in operation, pulmonary infection, are important factors that lead to post-operative ARDS after thoracotomy. Early treatment can reduce mortality of ARDS.
目的
探讨开胸术后急性呼吸窘迫综合征（ARDS）的病因，并找出预防ARDS的措施。
方法
分析31例开胸术后ARDS的发病率、致病性及治疗特点。
结果
患有慢性阻塞性肺疾病、长期吸烟史、高血压的患者易发生ARDS。手术中肺损伤、休克和肺部感染可能导致ARDS。清除呼吸道分泌物、保持气道通畅、控制肺部感染、利尿减轻肺水肿、早期行气管切开术或经气管插管机械辅助通气是成功抢救患者的关键。
结论
提示开胸术后ARDS与多种因素有关。休克、手术中肺损伤、肺部感染是导致开胸术后ARDS的重要因素。早期治疗可降低ARDS的死亡率。
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