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目的 :探讨高海拔地区急性呼吸窘迫综合征 (ARDS)发病机理、临床特点、诊断标准及治疗措施 ;方法 :40例ARDS ,其中多器官功能障碍 1 4例 ,单纯用HFV治疗 2例 ,IPPV治疗 1 0例 ,交替通气方式HFV、IPPV或CMV治疗 1 6例 ,CMV或PSV治疗1 2例 ,血气分析 :PaO2 3 5mmHg～ 60mmHg( 4.66kPa～ 7.98kPa) ,平均 55mmHg( 7.3 2kPa) ,PaCO2 2 5mmHg～ 80mmHg( 3 .3 3kPa～ 1 0 .64kPa) ,平均 45mmHg( 5.99kPa) ,PaO2 /FiO2 40mmHg～ 2 0 0mmHg( 5.3 2kPa～ 2 6.60kPa) ,平均 1 80mmHg( 2 3 .94kPa) ,P(A -a)O2 (FiO2 =1 ) 1 50mmHg～ 2 50mmHg( 1 9.95kPa～ 3 3 .2 5kPa) ,平均 2 0 0mmHg( 2 6.60kPa) ,SaO2 40 %～ 90 % ,平均 85% ;结果 :全组治愈 3 3例 ,死亡 7例 ,死亡率 1 7.5% ;结论 :高海拔、低氧更易诱发急性肺损伤 (ALI)、ARDS ,并且起病急、进展快 ,早期合并心功能障碍者多 ,PaO2 /FiO2 ≤ 2 50mmHg( 3 3 .2 5kPa) (ALI) ,≤ 1 80mmHg( 2 3 .94kPa) (ARDS)为本地区临界值 ,及早应用机械通气可提高治愈率 ,中医中药可防治ARDS。
Objective: To investigate the pathogenesis, clinical features, diagnostic criteria and treatment of acute respiratory distress syndrome (ARDS) in high altitude areas. Methods: 40 cases of ARDS, including 14 cases of multiple organ dysfunction, 2 cases of HFV alone and IPPV One hundred and sixteen cases were treated by alternating ventilation with HFV, IPPV or CMV, and 12 cases were treated with CMV or PSV. PaO2 3 5 mmHg to 60 mmHg (4.66 kPa to 7.98 kPa), average 55 mmHg (7.3 2 kPa) and PaCO 2 2 An average of 45 mmHg (5.99 kPa), PaO2 / FiO2 40 mmHg to 200 mmHg (5.32 kPa to 2 6.60 kPa), an average of 180 mmHg (23.94 kPa), and P (A-a) O2 (FiO2 = 1) 1 50mmHg ~ 250mmHg (1 9.95kPa ~ 3 3 .25kPa) with an average of 200mmHg (2 6.60kPa) and SaO2 40% ~ 90% with an average of 85% : The group of cured 33 cases, 7 deaths, the mortality rate was 7.5%; Conclusion: High altitude, hypoxia more likely to induce acute lung injury (ALI), ARDS, and acute onset, rapid progress, early with cardiac dysfunction (PaO2 / FiO2 ≤250mmHg (32.5kPa) (ALI), ≤180mmHg (23.9kPa)) (ARDS) as the regional critical value, the early application of mechanical ventilation can improve governance Rate, Chinese medicine can prevent ARDS.