重症肺炎护理查房-(2)课件

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1、2013625,鷿,鷿,1.弰 2. 3., 77 20136320:40 CAD 4 󺹣86/50mmhg114/IABPCABG,7-8160/70mmhg140/70mmhg򲡰6-10mmol/l8 103/30 ,2013690-95% 6516:11100-140/40-55mmhg100/8l/minSpo2 99%, 6610l/minSpo2 95%,6810:0010L5L,100/37mmhgSpo2 86%50mmhg105/40mmhg105bpa40 6815:52100mg/h 690700 610Bi-level94/47mmhg

2、,Spo2 83-88% 611SIMVSpo2 83-90%,612SIMVSPO2 88-92%, 613 61410 615SIMV27+PS2085/73/39mmhgSPO2 78-89%132027/22mmhg飬1334, PaO2 88mmhg PCO2 46mmhg 6.4,03:40 PaO2 76mmhg PCO2 32mmhg󼴿 6.4,06:22PaO2 99mmhg PCO2 99mmhg(fio2 80% 6.5,05:00PaO2 83mmhg PCO2 27mmhg(fio2 60% 6.5 PaO2 79mmhg PCO2 31mmhg 6

3、.6PaO2 59-75mmhg PCO2 31-32mmhg10L/min 6.7PaO2 50-68mmhg PCO2 24-28mmhg10L/+5L/ 6.8PaO2 46- 52mmhg PCO2 25-33mmhg10L/+5L/ fio2 100% 6.9PaO2 39-50mmhg PCO228-40mmhg fio2 100% 6.14PaO2 40-46mmhg PCO2 61-69mmhg 6.15PaO2 42-51mmhg PCO2 51-57mmhg , 64 WBC:12.74 3.5-9.5 /L 80.2 40-75 % 65 WBC:12.51 75.2 6

4、6 WBC:15.15 84.9 69 WBC 12.67 93.8 610WBC21.06 / 612WBC24.34 / 615WBC33.63 / 6.4-6,2g6.73g 6.810000.5g 6.90.6g,0.5g 6.140.4g,:,6.4-6.6: 2g6.73g 6.8: 10000.5g 6.9: 0.6g,0.5g 6.14: 0.4g, .,.,壬壬 , ,彻 PC ,彻 1.30-602.3. : 1. 2. 24 3., 塣仯 1. 2.綯 仯, 1 31-2洲 430 5,缫𲫵 1.硢棬 2. 缫3 d𴲡 3.豸, 20-80

5、 10 ,continuous renal replacement therapy CRRT,CRRT , ARFARDSMODS CRRT 3040CRRT,CRRT,1. 2.CRRT 3.CVPCVP仯,4.趨仯仯 5.1 6.緢,Severe pneumonia ,(CAP) (HAP) 1.ICU (VAP) 2. 3.,CAP/HAP, 1.? 30/min 2. PaO2250 3. 4. 90mmHg 5. 60mmHg, 1. 2.48h ? 50% 3. 4. ( 177mol/L( 2mg/dl),12, ., ,systemic inflammatory response syndrome, SIRSinfection(inflammation)SIRS.WBC12.0109/L4.0109/L0.10, 1. 1ml/kgh DIC 礣 :,DIC 礣,棺 1) .2) 3) 1. 𣬽2. 򵰰,2. 1 BiPAPFiO 2 50%100% 2 񻯣X+PSV+PEEPARDS,3. 豣農20g/d 4. 򵰰,Thank You !,