ral prevention and management were adopted，including methylprednisolone 250～500mg，serum albumin 10g，furosemide 20mg，ulinastatin 200 000u，bid iv，mucosolvan 30mg，tid iv，intestinal nutrition in time and liquid sustain reasonably.Results Before treatment，there was no significant difference(P＞0.05) between two groups about the ages(42.9±13.89 vs 39.9±19.37y)，PaO2 (68.4±15.76vs 67.63±15.01mmHg)，PaCO2(31.97±5.54 vs 28.26±5.29mmHg) and the score of APACHEⅡ (18.38±3.2 vs 19.5±16.76).When the general prevention and management project was adopted for 24 hours，the increase of PaO2(91.88±14.79mmHg) in the treatment group was higher than that of the control group(73.99±14.67mmHg)(P＜0.001 .The results showed that the incidence of ARDS，MODS，ventilation associated pneumonia and the mortality were significantly lower(P＜0.005，P＜0.025，P＜0.005，P＜0.05，respectively) than the control group(15.2% vs 64.3%，7.69% vs 35.71%，7.69% vs 30.77%，3.85% vs 30.77%，respectively).The number of days of mechanical ventilation and the hospitalized was shorter(P＜0.001) than the control group(7.38±2.69 vs 20.33±16.15 and 18.92±10.83 vs 44.45±29.30d).Conclusion Using early detection，diagnosis and general prevention and management，it can effectively control the occurrence and development of pulmonary contusion with acute lung injury，and it is one important factor to improve the patients prognosis.
【Key words】 pulmonary contusion acute lung injury(ALI) early general prevention and management prognosis
严重肺挫伤并发急性肺损伤(ALI)易恶化为急性呼吸窘迫综合征(ARDS)，后者预后差，病死率高［1］。近年来上海长征医院急救科ICU在原救治基础上早期采用综合防治方案，降低肺挫伤并发ALI、ARDS的发生和发展，改善患者预后，取得较满意临床疗效。本文分析54例严重肺挫伤并发ALI患者临床资料，探讨早期综合防治对本病患者预后的影响。
1 资料与方法
1.1 临床资料 本资料来源于2000年1月～2003年1
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