目的分析严重肺挫伤机械通气 治疗疗效及影像学变化。方法 选取2015 年1月-2018年1月我院收治的120例行机械 通气治疗的严重肺挫伤患者纳入研究， 观察患者治疗前与治疗24h后呼吸频率 (RR)、心率(HR)、血气分析指标[血氧分 压(PaO2)、氧合指数(PaO2/FiO2)、二氧 化碳分压(PaCO2)]、恢复情况[血氧饱和 度(SpO2)恢复为95%时间、湿啰音消失时 间、机械通气时间、住ICU时间]、临床疗 效，并分析患者治疗前后影像学变化。结 果 与治疗前相比，患者治疗24h后RR、 HR、PaCO2均明显降低(P＜0.05)，PaO2、 PaO2/FiO2明显升高(P＜0.05)；患者SpO2 恢复为95%时间(27.46±2.83)min、湿 啰音消失时间(61.78±6.35)min、机械 通气时间(5.24±0.67)d、住ICU时间 (7.12±0.76)d；疗效优87.50%，8.33%， 差6.67%由于多脏器功能障碍综合征致 死；CT图像可清晰呈现肺挫伤范围、密度 以及病情演变过程。结论 机械通气治疗 可有效改善严重肺挫伤患者呼吸与血气分 析指标，促进SpO2与临床体征恢复，降低 病死率，疗效良好，CT图像对其早期诊治 与预后评估具有指导价值。

Objective To analyze the curative effect of mechanical ventilation for severe pulmonary contusion and imaging changes. Methods One hundred and twenty patients with severe pulmonary contusion who underwent mechanical ventilation in the hospital from January 2015 to January 2018 were enrolled in the study. The respiratory rate (RR), heart rate (HR), blood gas analysis indicators [partial pressure of blood oxygen (PaO2), oxygenation index (PaO2/FiO2), partial pressure of carbon dioxide (PaCO2)], recovery [time for oxygen saturation (SpO2) restoring to 95%, disappearance of wet rales, mechanical ventilation time, length of ICU stay] and clinical efficacy were observed. Imaging changes before and after treatments were analyzed. Results The RR, HR and PaCO2 were significantly decreased after 24 hours of treatment (P<0.05), while PaO2 and PaO2/FiO2 were significantly increased (P<0.05). The time for SpO2 restoring to 95%, disappearance of wet rales, mechanical ventilation time and length of ICU stay were (27.46±2.83) min, (61.78±6.35) min, (5.24±0.67) days and (7.12±0.76) days, respectively. The excellent, good and poor rates of efficacy were 87.50%, 8.33% and 6.67%, respectively. Multiple organ dysfunction syndrome caused death. CT images clearly showed the extent, density and development of pulmonary contusion. Conclusion Mechanical ventilation therapy can effectively improve the respiratory and blood gas analysis indexes in patients with severe pulmonary contusion, promote recovery of SpO2 and clinical signs and reduce the mortality rate, with good curative effect. CT images are of guiding value for early diagnosis and treatment and evaluation of prognosis.