摘要
Abstract
Objective To analyze the clinical features of differentiation syndrome ( DS ) with acute respiratory distress syndrome ( ARDS ). Methods The clinical data including clinical presentations, laboratory findings, treatment and prognoses of 8 DS patients with ARDS who were treated in our hospital from May 2005 to October 201 1 were retrospectively analyzed. Results The onset symptoms included fever, fatigue, and bleeding. Patients were treated with induction therapy with retinoic acid, and then developed shortness of breath, difficulty in breathing, and high fever; Body weight increased by >5 kg in 4 patients, and two patients developed hypotension and one suffered from renal dysfunction. In 5 patients, chest X - ray showed thickened and blurred lung texture, with diffuse patchy cloudy shadows of various sizes; The borders were unclear, or the patchy shadows fused and showed diffuse exudative changes. Three patients received computed tomography ( CT ), which showed multiple patchy or ground - glass like high - density shadows, with less cleat- borders. Atelectasis at the lower lung or pleural effusion was detected in 2 patients. All patients were given orotracheal intubation and mechanical ventilation. The condition was improved after treatment in 4 patients, with elevated oxygenation index; Chest X -ray showed the pulmonary exudate was absorbed. After 10-18 days of mechanical ventilation blood gas analysis showed basically normal results, and the pulmonary exudate was absorbed. Patients were then withdrawn from the ventilator and extubated. Clinical response was achieved riming the follow - up treatment. Two patients had non - adjustable hypoxia, 1 had concurrent bilateral pneumothorax, and 1 develped disseminated intravascular coagulation ( DIC ); All these four patients died. Conclusion DS with ARDS can have high mortality rate. There-for, eartv diagnosis, earty intervention, and appropriate treatment are critical to improve the outcomes.关键词
分化综合征/白血病,早幼粒细胞,急性/呼吸窘迫综合征,成人Key words
Differentiation syndrome /Leukemia, promyelocytic, acute/Respiratory distress syndrome, adult分类
医药卫生
