摘要
目的研究肺源性急性呼吸窘迫综合症(ARDSp)与肺外源性急性呼吸窘迫综合症(ARDSexp)临床特征的差异。方法选择2014年10月至2016年10月于郑州市第六人民医院接受治疗的ARDS患者共200例,其中ARDSp 116例,ARDSexp 84例,记录患者年龄、性别、慢性病史、入重症监护室原因等,危险重病学评分及患者化验指数,采用SPSS20.0统计软件进行对比分析。结果肺源性组患者116例,其中肺部受到感染92例,肺部挫伤7例,溺水4例,误吸13例,肺部感染是肺源性组发病的主要因素;肺外源性组患者84例,其中脓毒症42例,休克8例,急性胰腺炎19例,神经源性、弥漫性血管内凝血和输血关联性各5例,脓毒症是肺外源性组发病的主要因素。肺源性组和肺外源性组患者的急性生理与慢性健康的评分分别为(18.31±6.68)和(18.49±5.99),肺部损伤评分分别为(2.68±0.49)和(2.47±0.70),差异均无统计学意义(P>0.05)。肺源性组和肺外源性组患者使用呼气末正压通气(PEEP)平均值分别为(12.35±5.19)和(9.01±4.02)cm H2O,差异有统计学意义(t=2.87,P=0.045)。肺源性患者和肺外源性患者在治疗期间死因大多是人体器官功能的衰竭,其中肺源性组患者的死亡率为47.41%,肺外源性组患者的死亡率为36.90%。结论两组患者在扭转体内氧合方面肺外源性组使用PEEP的效果更好,同时ARDSexp患者发生肾功能衰竭的几率也更低。
Objective To study the epidemiology and clinical characteristics of acute respiratory distress syndrome ofpulmonary origin（ARDSp） and acute respiratory distress syndrome of extyapulmonary（ARDSexp）. Methods FromOctober 2014 to October 2016 in Zhengzhou city sixth people′s Hospital for the treatment of ARDS patients in 200 cases,ARDSp 116 cases, ARDSexp 84 cases;a detailed record of the age and sex of patients, chronic disease, ICU and otherreasons, dangerous illness scores and patients with laboratory index, were analyzed by SPSS20.0 statistical software.Results There were total 116 cases,including lung infection in 92 cases,lung contusion in 7 cases,drowning in 4 casesand 13 cases were wrongly absorbed. Pulmonary infection was the main factor in the pathogenesis of the pulmonary group. 84 cases of pulmonary exogenous group,including 42 cases of sepsis patients,8 cases of shock patients,19 cases of acutepancreatitis,and 5 cases of neurogenic,disseminated intravascular coagulation and blood transfusion related. Sepsis was themain factor in the incidence of lung exogenous group. The scores of acute physiology and chronic health were（18.31±6.68）and（18.49 ± 5.99）,respectively,and the scores of lung injury were（2.68 ± 0.49）and（2.47 ± 0.70）,respectively,thedifference was not statistically significant（P〈0.05）. The mean values of positive end expiratory pressure（PEEP） were（12.35±5.19）and（9.01±4.02）cm H2 O,respectively,and the difference was statistically significant（t=2.87,P=0.045）.Death of the lung patients and exogenous patients during the treatment were mostly due to human organ function failure,ofwhich the mortalities of the lung patients and exogenous patients were 47.41% and 36.90%,respectively. Conclusion Toreverse the body oxygenation,the use of PEEP in the lung exogenous group was better than the lung patients,whileARDSexp patients were also less likely to develop renal failure
作者
马和伟
MA He-wei(Department of lntensive Cure Unit, Sixth People＇s Hospital of Zhengzhou , Zhengzhou , Henan 450000, Chin)
出处
《热带医学杂志》
CAS
2017年第9期1222-1224,共3页
Journal of Tropical Medicine
