摘要
目的探讨重症胸外伤并发急性呼吸窘迫综合征(acute respira-tory distress syndrome,ARDS)的高危因素。方法回顾性分析本院2013年6月至2016年6月收治的328例重症胸外伤患者的临床资料,分析重症胸外伤并发ARDS与患者性别、年龄、入院时血压、是否伴有呼吸困难(呼吸频率≥28次/分或<10次/分)、是否吸烟、动脉血氧分压(arterial partial pressure of oxygen,PaO_2)、动脉血二氧化碳分压(arterial partial pressure of carbon dioxide,PaCO_2)、肺挫伤、肺部疾病、呕吐误吸、腹内脏器损伤、格拉斯哥昏迷评分(Glasgow coma score,GCS)、损伤严重程度评分(injury severity score,ISS)之间的相关性。结果年龄≥65岁、肺挫伤、肺部疾病、呼吸困难、PaO_2<60 mmHg、PaCO_2≥45 mmHg或≤36 mmHg、呕吐误吸、腹内脏器损伤、GCS≤8分、ISS≥16分是重症胸外伤并发ARDS的高危因素(P<0.05)。结论年龄≥65岁、肺挫伤、肺部疾病、呼吸困难、血气胸、PaO_2<60 mmHg、PaCO_2≥45 mmHg或≤36 mmHg、呕吐误吸、腹内脏器损伤、GCS≤8分、ISS≥16分是重症胸外伤并发ARDS的高危因素,应引起足够的关注。
Objective To explore the risk factors of severe thoracic trauma complicated with acute respiratory distress syndrome（ARDS）. Method The clinical data of 328 patients with severe thoracic trauma from June 2013 to June 2016 were retrospectively analyzed, the correlation between severe thoracic trauma complicated with ARDS and the sex, age, blood pressure at admission, whether combined with dyspnea（respiratory rate ≥ 28 times/min or 10 times/min）, whether smoking, arterial partial pressure of oxygen（PaO2）, arterial partial pressure of carbon dioxide（PaCO2）, lung contusion, pulmonary diseases, vomiting aspiration, intraperitoneal organ injury, Glasgow coma score（GCS）, injury severity score（ISS） of 328 patients were analyzed. Result ≥ 65 years old, lung contusion, pulmonary diseases, dyspnea, arterial PaO2 60 mmHg, arterial PaCO2≥ 45 mmHg or ≤ 36 mmHg, vomiting aspiration, intraperitoneal organ injury, GCS ≤ 8 points and ISS ≥ 16 points were high risk factors of severe thoracic trauma complicated with ARDS（P〈0.05）. Conclusion ≥ 65 years old, lung contusion, pulmonary diseases, dyspnea, PaO2 60 mmHg, PaCO2≥ 45 mmHg or ≤ 36 mmHg, vomiting aspiration, intraperitoneal organ injury, GCS ≤ 8 points and ISS ≥ 16 points were high risk factors of severe thoracic trauma complicated with ARDS, should be given enough attention.
出处
《中国医学前沿杂志（电子版）》
2017年第10期113-116,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
重症胸外伤
急性呼吸窘迫综合征
危险因素
Severe thoracic trauma
Acute respira-tory distress syndrome
Risk factors
