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目的探讨影响急性呼吸窘迫综合征(ARDS)患儿死亡的相关因素。方法收集了符合ARDS诊断标准的患儿共25例,检测血清SP-A、IL-8、IL-10、基础皮质醇水平,记录呼吸机使用参数、机械通气时间及住院时间,并进行统计学分析。结果死亡组患儿血清SP-A、IL-8、IL-10水平、机械通气最高PEEP显著高于存活组ARDS患儿,基础皮质醇水平、最低PaO2/F iO2显著低于存活组患儿。存活组患儿住院时间、机械通气时间显著长于死亡患儿。肺内源性ARDS机械通气最高PEEP显著高于肺外源性ARDS患儿,最低PaO2/F iO2显著低于肺外源性ARDS。ARDS患儿预后与血清IL-10水平、SP-A水平、住院时间有关,是影响ARDS死亡的主要危险因素。结论调节炎性/抗炎的平衡,肺表面活性蛋白的替代,改善肾上腺皮质功能不全,并结合先进的呼吸机治疗技术,从多方面入手综合治疗ARDS有助于改善预后。
Objective To investigate the related factors affecting the mortality of children with acute respiratory distress syndrome (ARDS). Methods A total of 25 children with ARDS were enrolled in this study. Serum levels of SP-A, IL-8, IL-10 and basal cortisol were measured. Ventilator parameters, mechanical ventilation and hospital stay were recorded. analysis. Results The serum levels of SP-A, IL-8 and IL-10 in the death group and the highest PEEP in the mechanical ventilation group were significantly higher than those in the survival group. The basal cortisol level and the lowest PaO2 / F iO2 in the death group were significantly lower than those in the surviving group. Survival group hospitalization time, mechanical ventilation was significantly longer than the death of children. The highest PEEP of pulmonary endogenous ARDS was significantly higher than that of pulmonary exogenous ARDS, and the lowest PaO2 / F iO2 was significantly lower than that of exogenous ARDS. ARDS children with prognosis and serum IL-10 levels, SP-A levels, hospital stay, are the major risk factors for ARDS death. CONCLUSIONS: Regulating inflammatory / anti-inflammatory balance, surrogate of pulmonary surfactant protein, and improving adrenal insufficiency, combined with advanced ventilator therapy, can help improve prognosis by comprehensively treating ARDS.