重症肺炎就是ARDS吗?

doi:10.16138/j.1673-6087.2024.01.04

摘要/Abstract

摘要：

急性呼吸窘迫综合征(acute respiratory distress syndrome, ARDS)是在严重感染、休克、创伤及烧伤等疾病过程中导致的急性低氧性呼吸功能不全，容易与重症肺炎合并低氧血症和重症新型冠状病毒肺炎等疾病相混淆。本文就ARDS的概念、发病机制、病理改变、病理生理以及定义进行了论述，并与重症肺炎合并低氧血症和重症新型冠状病毒肺炎的临床表现等异同进行深入的分析和解读。

关键词: 急性呼吸窘迫综合征, 重症肺炎, 病理生理

Abstract:

The acute respiratory distress syndrome (ARDS) is an acute hypoxic respiratory insufficiency caused by severe infection, shock, trauma and burns. It is easily confused with severe pneumonia combined with hypoxemia and severe COVID-19 pneumonia. In this paper, the concept, pathogenesis, pathological changes, pathophysiology and definition of ARDS were discussed, and the similarities and differences between ARDS and severe pneumonia combined with hypoxemia or severe COVID-19 pneumonia were analyzed and conducted in-depth interpretation.

Key words: Acute respiratory distress syndrome, Severe pneumonia, Pathophysiology

中图分类号:

R563.1

何权瀛. 重症肺炎就是ARDS吗?[J]. 内科理论与实践, 2024, 19(01): 19-24.

HE Quanying. Is severe pneumonia ARDS?[J]. Journal of Internal Medicine Concepts & Practice, 2024, 19(01): 19-24.

图/表 1

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项目	标准
次要标准	呼吸频率≥30次/min
	PaO₂/FiO₂≤250 mmHg
	多肺叶受累
	意识障碍
	尿毒症（尿素氮≥200 mg/L）
	白细胞减少（<4 000个/mm³）
	血小板减少（<100 000个/mm³）
	体温过低（<36℃）
	低血压需要液体复苏
主要标准	需行有创机械通气
	感染性休克需要应用血管活性药物