摘要
目的：探讨不同海拔梯度创伤性ＡＬＩＡＲＤＳ 发病机制、几率、特征和早期防治。方法：按ＡＬＩＡＲＤＳ记分标准将发生在海拔１５００ｍ（ 兰州） 以胸伤为主与（ 或） 多发伤病例，ＡＩＳＩＳＳ 院内记分在２０ 分以上的２６ 例列为Ａ 组，将２２６０ｍ（ 西宁） 伤情配比近似Ａ 组的２２ 例列为Ｂ 组，观察两组自受伤—院内救护至发生ＡＬＩＡＲＤＳ的时间、发病特点、几率、临床病征、血气变化。结果：在伤情相近，原发伤处理相近的条件下，Ｂ 组ＡＲＤＳ临床过程、发病几率及其监测指标显著早于、重于、多于Ａ 组（ Ｐ＜ ０ ．０１ 或Ｐ＜ ０ ．０５） 。但病死率两组相近。结论：高海拔区创伤性ＡＬＩＡＲＤＳ 可能具有缺氧、创伤双重打击因素和高压性与高渗性混合性肺水肿双重病理生理性质。诊断标准应有别于平原地区标准。
Aim:To investigate risk factors of traumatic acute lung injury(ALI)/ARDS and it's pathophysiological mechanisms,and characteristic features at the different altitudes above sea level.Clinical material and methods:A standard couple test by AIS ISS scale were used both in high gradient of 1500m (group A,N=26) and 2260m(group B,N=22).The same parameters were recorded and measured at the same time intervals.Results:The results of this study showed that the clinical symptoms and signs,pathophysio characteristics and blood gas analysis were different significantly between group A and group B.Onset of the ALI/ARDS in group B was much earlier than group A and its clinical condition was much worse.Conclusions:ALI/ARDS happens above 2260m sea level may be a border line with it's mechanisms and pathophysio characteristics.Both hypoxia and trauma may play important role in formation of altitude ALI/ARDS.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
1999年第6期337-339,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
