Britto J, Demling R H
Longwood Area Trauma/Burn Center, Brigham and Women's, Beth Israel, and Children's Hospital, Boston, MA.
New Horiz. 1993 Aug;1(3):435-9.
Aspiration lung injury is caused by a failure of the normal protective mechanisms that prevent aspiration of gastric contents. Prevention measures are focused on preserving these protective mechanisms. There are three components to the lung injury. The first component is mechanical obstruction to airways from particles in the aspirate. Treatment is aggressive pulmonary toilet to restore airway patency. The second component, seen beginning in the first several hours, is a chemical injury to the airways, leading initially to bronchorrhea, airway constriction, and edema. Later, there is a marked increase in the risk of bacteria due to altered lung defenses. Treatment is supportive care. The third component is lung injury due to the inflammatory response. This process can evolve to an adult respiratory distress syndrome pattern. With modulation of lung inflammation (currently being developed), morbidity and mortality rates will decrease.
误吸性肺损伤是由正常保护机制失效导致胃内容物误吸引起的。预防措施着重于维持这些保护机制。肺损伤有三个组成部分。第一个组成部分是误吸物中的颗粒对气道造成的机械性阻塞。治疗方法是积极进行肺部灌洗以恢复气道通畅。第二个组成部分在最初几个小时开始出现，是气道的化学性损伤，最初导致支气管分泌增多、气道收缩和水肿。后期，由于肺部防御功能改变，细菌感染风险显著增加。治疗是支持性护理。第三个组成部分是炎症反应导致的肺损伤。这个过程可能演变成成人呼吸窘迫综合征模式。随着对肺部炎症的调控（目前正在研发中），发病率和死亡率将会降低。
