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[创伤患者早期通气的适应证及诊断标准]

[Indications and diagnostic criteria for early ventilation of trauma patients].

作者信息

Riemenschneider V T, Junginger W

机构信息

Abteilung Allgemeine Chirurgie, Universität Tübingen.

出版信息

Zentralbl Chir. 1988;113(8):485-90.

PMID:3041709
Abstract

Mechanical ventilation is the potential therapeutic approach to traumatic brain lesion and acute adult respiratory distress syndrome (ARDS) in the wake of severe injury in an accident. Aggravating cerebral symptoms, such as non-targeted defence reactions in coma, hemiplegia, synergism of extension, convulsions, pontine respiratory disorders, and intracerebral pressure beyond 30 Torr are diagnostic criteria for immediate mechanical ventilation of patients with brain trauma. The same action is indicated for cases of ARDS exhibiting, on top of the typical constellation of causes, hypoxia below 60 Torr paO2 and vital capacity below 15 ml/kg body weight or respiratory rates in excess of 30/min.

摘要

机械通气是治疗因事故严重受伤后出现的创伤性脑损伤和成人急性呼吸窘迫综合征(ARDS)的潜在治疗方法。加重脑部症状,如昏迷时的非针对性防御反应、偏瘫、伸展协同作用、抽搐、脑桥呼吸障碍以及颅内压超过30托,是脑外伤患者立即进行机械通气的诊断标准。对于ARDS病例,如果除了典型的病因组合外,还出现动脉血氧分压(PaO2)低于60托、肺活量低于15毫升/千克体重或呼吸频率超过30次/分钟,也建议采取同样的措施。

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