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一、历史 ARDS 是在近十几年来才被公认为一种急性呼吸衰竭为主要表现的综合征。回顾早至1914年 Pasteur 曾报告过“肺大面积萎陷综合征”。第一次世界大战期间已认识到创伤后能引起广泛肺不张综合征,多发生于枪伤之后。Braford 报告这种综合征开始为小面积肺不张,以后进而发展为双肺不张。第二次世界大战期间,由于休克治疗的进步,严重创伤存活率增高,但同时发现所谓“创伤性湿肺”的增加。Moon 曾发现死于严重创伤性休克的士兵中肺不张、充血及水肿的发生率很高。1950年 Jenkins 等描述了7例由于创伤、外科手术或败血症引起呼衰死亡的病例,称之为“充血性肺不张”。1960年 Baer 及 Os-born 注意到体外循环直视手术后死于呼衰的患者有灶性肺不张、肺水肿及小血管扩张。美国侵越战争期,因战伤外科的进步,直升飞机很快地把重伤患者撤至后方医院,许多伤员在休克纠正、手术成功后不久(12～48小时内)死于急性呼吸衰竭,因当时战场在 Da Nang 故曾称为 Da Nang 肺(Kevin)。以后 B.Lake 发现其他原因引起休克,恢复期也可发生急性呼吸衰竭,故在一个相当长时期内称之谓“休克肺”。
First, the history of ARDS is in the past ten years before it was recognized as an acute respiratory failure as the main manifestation of the syndrome. As early as 1914, Pasteur reported “large lung collapse syndrome.” During World War I, it was recognized that trauma can cause widespread atelectasis and often occurs after gunshot wounds. Braford reported that the syndrome started as a small area of atelectasis and later developed into atelectasis. During World War II, severe traumatic survival increased due to the progress of shock treatment, but at the same time, increased so-called “traumatic wet lungs” were found. Moon found a high incidence of atelectasis, congestion and edema in soldiers who died of severe traumatic shock. In 1950, Jenkins et al. Described seven cases of death from respiratory failure as a result of trauma, surgery or sepsis, and called “congestive atelectasis.” In 1960 Baer and Os-born noted focal atelectasis, pulmonary edema and small vessel dilatation in patients who died of respiratory failure after CPB. During the period of the American invasion during the war, due to advances in war surgery, helicopters quickly pulled patients seriously injured to the rear hospital. Many of them died of acute respiratory failure shortly after operation (12 to 48 hours) due to shock correction The battlefield was once known as Da Nang lung (Kevin) in Da Nang. After B. Lake found other causes of shock, convalescent acute respiratory failure can occur, so in a fairly long period of time that the “shock lung.”