Wu Jun-song, Sheng Lei, Ma Yue-feng, Wang Shen-hua, Zhou Wen, Chen Jin-ming, Zhang Mao, Xu Shao-wen, Jiang Guan-yu
Emergency Department, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Zhonghua Yi Xue Za Zhi. 2009 Jun 16;89(23):1602-6.
To investigate the potential risk factors of affecting progression from acute lung injury (ALI) to acute respiratory distress syndrome in severe trauma population.
Twenty potential risk factors of affecting progression of acute lung injury were examined by univariate and multivariate logistic analyses among the severe trauma patients in a retrospective study.
All of 375 specially severe trauma patients with ALI were included for analysis. The six risk factors that affected the progression from acute lung injury to acute respiratory distress syndrome were sepsis, duration of trauma, APACHE II score, DIC, aspiration of gastric contents, and advanced age. Specific risk factors also affected different patient subpopulations at different degrees.
Impact of sepsis, DIC and duration of trauma that predict progression of ALI exists throughout the entire treatment period while aspiration of gastric contents and APACHE II score might affect aggravation of ALI only during the early period; due to deterioration of pulmonary function and severely traumatic injury, advanced age is still an independent risk factor; patients with these risk factors need aggressive supportive cares as early as possible in order to prevent further aggravations.
探讨严重创伤人群中影响急性肺损伤（ALI）进展为急性呼吸窘迫综合征的潜在危险因素。
在一项回顾性研究中，对严重创伤患者的20个影响急性肺损伤进展的潜在危险因素进行单因素和多因素逻辑分析。
纳入375例特别严重的ALI创伤患者进行分析。影响急性肺损伤进展为急性呼吸窘迫综合征的六个危险因素为脓毒症、创伤持续时间、急性生理与慢性健康状况评分系统（APACHE）II评分、弥散性血管内凝血（DIC）、胃内容物误吸和高龄。特定危险因素也在不同程度上影响不同的患者亚群。
脓毒症、DIC和创伤持续时间对ALI进展的影响在整个治疗期间都存在，而胃内容物误吸和APACHE II评分可能仅在早期影响ALI的加重；由于肺功能恶化和严重创伤损伤，高龄仍然是一个独立的危险因素；有这些危险因素的患者需要尽早进行积极的支持治疗，以防止进一步加重。
