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目的比较肺部原因诱发的急性呼吸窘迫综合(ARDSp)和肺外原因诱发的ARDS(ARD-Sexp)临床特征,为指导临床科学治疗ARDS提供研究资料。方法收集128例ARDS患者的临床资料,据病因分为ARDSp组和ARDSexp组,通过回顾性分析总结两组发病年龄、性别、基础疾病、影像学表现与全身性炎症反应综合征的关系、多器官功能障碍综合征的发生率、预后等方面的异同点。结果①ARDSp组以肺炎最多见,ARDSexp组最多见的是脓毒症、其次是重症胰腺炎。②两组在APACHEⅡ-评分、氧合指数、住院天数、VALI的发生率、与全身性炎症反应综合征的关系等方面无统计学差异。③ARDSexp组MODS发生率、死亡率明显高于ARDSp组,差异有统计学意义(P<0.05)。结论ARDSexp组的MODS发生率、死亡率、影像学表现毛玻璃样变显著高于/多于ARDSp组,但两组患者在疾病严重程度(以APACHEⅡ-评分衡量)、与SIRS的关系等方面无统计学差异。
Objective To compare the clinical characteristics of acute respiratory distress syndrome (ARDSp) induced by pulmonary causes and ARDS (ARD-Sexp) induced by extrapulmonary causes and provide the research materials for clinical ARDS. Methods The clinical data of 128 patients with ARDS were collected and divided into ARDSp group and ARDSexp group according to their etiology. The relationship between the age, gender, underlying diseases, imaging findings and systemic inflammatory response syndrome was analyzed retrospectively. The incidence of dysfunction syndrome, prognosis and other aspects of the similarities and differences. Results ① The pneumonia was the most common in ARDSp group, the most common in ARDSexp group was sepsis, followed by severe pancreatitis. ② There was no significant difference between the two groups in APACHE Ⅱ-score, oxygenation index, hospital stay, the incidence of VALI and the relationship with systemic inflammatory response syndrome. ③ The incidence and mortality of MODS in ARDSexp group were significantly higher than those in ARDSp group (P <0.05). CONCLUSIONS: MODS incidence, mortality, and imaging findings in ARDSexp group were significantly higher than those in ARDSp group (P <0.05). However, there was no statistical relationship between disease severity (measured by APACHE II-score) and SIRS Differences