【摘要】 目的分析重度烧伤患者并发ARDS的病因,治疗及预后。方法总结2006年3月至2008年3月武汉市第三医院烧伤重症监护室(BICU)收治的201例重度烧伤患者中19例并发ARDS的临床资料,包括致伤因素,入院前后的治疗措施及预后。所有病例入院后均采取补液抗休克、抗感染及维护重要脏器功能及营养支持治疗,同时监测中心静脉压、呼吸频率、SpO2、PaO2/FiO2、血气分析和X线胸片,一经ARDS诊断成立及早应用呼吸机治疗,我们采用保护性肺通气策略,呼吸模式采用SIMV+PEEP模式。结果重度烧伤患者201例中并发ARDS的病例19例,11例存活,死亡8例。其发病率为9.5%,病死率却高达54%。结论重度烧伤患者并发ARDS预后差,为重度烧伤患者的主要死因,应该早预防早治疗。更多还原

【Abstract】 Objective To analyse the etiological factor,treatment and prognosis of patients with severe burn accompanied with acute respiratory distress syndrome. Methods The clinical data of 201 cases with severe burn who admitted in BICU during March 2006 to March 2008 were collected, 19 of which suffered from ARDS. All the patients were given early fluid resuscitation, correcting shock, and correct use of antibiotics during early postburn stage,and nutritional support treatment. The CVP,respiratory rate, SpO2,PaO2/FiO2,blood gas analysis and chest X-ray examination were monitored. If ARDS was diagnosed, respiratory machine was given as soon as possible. We used the lung-protective ventilation strategy.The model was SIMV and PEEP. Results Among 19 patients with ARDS, 11 survived, 8 died The incidence rate was 9.5%, the mortality rate was as high as 54%. Conclusion ARDS is the mainly causes of Severe burn patients. We should pay more attention to prevention and treatment death in the early stage of this disease, though severe burns patients with ARDS showed a poor prognosis.更多还原