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《International Medicine & Health Guidance News》 2006-07
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显性吸入性肺炎及其所致急性呼吸窘迫综合征的临床分析

Objective To investigate the clinic manifestation、procedure, treatment and relative factor of prognosis in acute respiratory distress syndromn(ARDS) induced-dominant aspiration pneumo- nia in 14 cases with ARDS hospitalized patients from Aug 1999 to Feb 2004.Methods Monitoring dynamically dyspnea index, central venous press(CVP)and PaO2/FIO2, as well as the relative factor of prognosis such as total of leukocyte and blood glucose in the patients; the treatment included geting ride of inducement, inhaling oxygen, using antibiotics unitedly, allopathy and using fiberoptic bronchoscope to exhaust inhalant and secretion in time etc, as well as mechanical ventilation with 8~ 12cmH2O PEEP and Vt 4~7ml/kg. Result All appeared I-type respiratory failure: The dyspnea index increased significantly from 1.3 ±0.65 to 2.4 ±0.34 (P 0.01); on the contrary, PaO2/FIO2 and decreased significantly from (375 ±43.0) to (274 ±28.0) mmHg (P 0.01) in 6 hours(h); After treatment in 24 h, all monitoring index deteriorates significantly, and PaO2/FIO2200mmHg. after having mechanical ventilation with high PEEP and low Vt, CVP increased significantly. PaO2/FIO2 decreased significantly (172±55.0)mmHg in deathes compared with 212±48.0mmHg in suviver (P0. 01), total of leukocyte and blood glucose increased significantly after ventilation 72h; Meanwhile, the basic disorder and the morbidity of multiple organ dysfunction syndromn(MODS) high significantly in 8 deathes out of 14 patients. pH from inhalant and PaO2/FIO2 in 6h was not different beteewn deathes and suviver. Conclusion ARDS easily happened in early on dominant aspiration pneumonia. It is effective to use mechanical ventilation with high PEEP and low Vt based on general management. The prognosis depend on the response to treat after ventilation 72h, as well as controlling sepsis, glucomia and MODS.
【CateGory Index】: R563.1;R563.8
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