【摘要】 目的 探讨严重胸外伤并发急性呼吸窘迫综合征(ARDS)的临床诊断及防治。 方法 辅助呼吸模式为SIMV(同步间歇指令通气)+PSV(压力支持)+PEEP(呼气末正压)。参数:RR:16～24次/min，VT:6.0～8.0ml/kg，FiO 2 :0.40，PEEP:3～10cmH 2 O，PSV:8～12cmH 2 O，维持气道平台压<35cmH 2 O，治疗ARDS15例。 结果 15例机械通气时间4～12天，治愈出院14例，死亡1例，未发生气压伤现象，出现呼吸机相关肺炎2例。 结论 严重胸外伤如有机械通气指征，应及早使用。选用适当的通气模式和参数，可提高ARDS抢救成功率。

    关键词 胸部创伤 急性呼吸窘迫综合征 机械通气

    Severe thoracic trauma complicated with acute respiratory distress syndrome treated with mechanical ventilation:a report of15cases

    Zhang Yue，Qian Yongyue

    Department of Thoracic and Cardiovascular Surgery，The Second Hospital Affiliated to SoochowUniversity，Suzhou215004.

    【Abstract】 Objective To discuss the diagnosis and treatment of severe thoracic trauma complicated with res-piratory distress syndrome(ARDS).Methods Ventilative modes were synchronous intermittent mandatory ventilation(SIMV)，pressure support ventilation(PSV)and positive end expiratory pressure(PEEP).Parameters were the follow-ings:RR:16～24times/min，VT:6.0～8.0ml/kg，FiO 2 :0.40，PEEP:3～10cmH 2 O ......