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为研究 MAS合并 ARDS的临床特点 ,提出防治措施 ,及由临床与病理医师共同对逐例临床与病理资料进行回顾性分析 ,提出诊断与死因。结果显示 :1 .5 2例MAS合并 ARDS患儿病理镜检肺泡内均有胎粪小体及嗜伊红透明膜形成。 2 .MAS伴 ARDS时呼吸窘迫、青紫、三凹征及肺部罗音明显高于无 ARDS组 ,P均 <0 .0 1。3.ARDS的早期诊断线索 :1病史中患儿有宫内窘迫、产时窒息、胎粪羊水污染 °- °;2有上述症状与体征 ;3胸片有广泛性对称性密度增高或白肺 ;41 985年后用呼吸机治疗的 1 2例以常规参数难以纠正低氧血症 ,需提高压力特别是 PEEP;5肺泡动脉氧分压 (Aa DO2 ) >2 6 .7k Pa。本文章认为 ,对 ARDS提出 8点防治意见 ,关键是早期诊断及综合治疗。
In order to study the clinical features of AR combined with ARDS, the prevention and cure measures were put forward and the clinical and pathological data were retrospectively analyzed by clinicians and pathologists. The diagnosis and cause of death were put forward. The results showed that: 1. 52 cases of MAS combined with ARDS pathological examination of alveolar pneumophysis in both meconium-body and eosinophilic transparent membrane formation. MAS with ARDS respiratory distress, bruising, three concave signs and pulmonary rales were significantly higher than those without ARDS group, P <0. 1.3 1.3 early diagnosis of ARDS clues: 1 history of children with intrauterine Distress, obstruction during labor, meconium amniotic fluid contamination ° - °; 2 have the above symptoms and signs; 3 chest radiographs have increased symmetry or white lung; 41 after treatment with ventilator 41 2 5 cases with conventional parameters Difficult to correct hypoxemia, need to increase the pressure, especially PEEP; 5 alveolar arterial oxygen pressure (Aa DO2)> 26.7k Pa. This article argues that ARDS put forward eight points of prevention and treatment, the key is early diagnosis and comprehensive treatment.