摘要目的通过比较小儿急性呼吸窘迫综合征(ARDS)的病死率，分析影响ARDS患儿预后的相关因素。方法对38例ARDS患儿的ARDS类型、治疗过程中是否合并多器官功能紊乱综合征(MODS)以及家属治疗态度等因素进行分析。结果ARDS原发病中以脓毒血症病死率最高为66.67％（14/21）；治疗过程中合并MODS共8例（均为肺外型），死亡6例，病死率高达75.00％(6/8)，明显高于不合并MODS患儿的病死率[40.00％(12/30)]，差异有统计学意义(P＜0.05)；家属积极治疗可以降低患儿病死率(P＜ 0.05)；PaO2和PaO2/FiO2值肺外型低于肺内型，合并MODS患儿低于不合并MODS患儿，家属消极治疗者低于积极治疗者(P＜0.05);PaCO2值肺外型低于肺内型，家属消极治疗者低于积极治疗者(P＜ 0.05);pH值肺外型高于肺内型，合并MODS患儿高于不合并MODS患儿，家属消极治疗者高于积极治疗者(P＜0.05)。合并MODS的患儿危重病例评分明显低于不合并MODS的患儿，差异有统计学意义(P＜0.05)；家属积极治疗的患儿危重病例评分明显高于家属消极治疗的患儿，差异有统计学意义(P＜0.05)。结论肺外型原发病为脓毒血症、合并MODS、家属治疗态度消极对小儿ARDS的预后有影响。

abstractsObjective To analyse the prognostic factors of acute respiratory distress syndrome (ARDS) of children by comparing mortality in ARDS. Method ARDS type ,treatment process if there were multiple organ dysfunction syndrome (MODS), and whether family members actively cooperated with the treatment factors in 38 children with ARDS were analyzed. Results ARDS of the original mortality of sepsis was the highest[ 66.67％ ( 14/21 )]; treatment process combined with MODS in 8 cases, 6 died, the mortality up to 75.00％ (6/8), significantly higher than combined without MODS [40.00％ (12/30)],there was significant difference (P ＜ 0.05); family members actively cooperated with the treatment could reduce mortality of children (P ＜0.05); PaO2 and PaO2/FiO2 value:pulmonary-exterior type was lower than pulmonary-interior type, combined with MODS was lower than combined without MODS, family members actively cooperated with the treatment was lower than family members inactively cooperated with the treatment (P ＜ 0.05 );PaCO2 value:pulmonary- exterior type was lower than pulmonary-interior type, family members actively cooperated with the treatment was lower than family members inactively cooperated with the treatment (P ＜ 0.05 ) ; pH: pulmonary-exterior type was higher than pulmonary-interior type, combined with MODS was higher than combined without MODS, family members actively cooperated with the treatment was higher than family members inactively cooperated with the treatment (P ＜0.05);the critical illness score in family members with a positive attitude was higher than that in family members with a negative attitude (P ＜ 0.05).Conclusion The primary disease of sepsis, associated with MODS, the family members with a negative attitude toward the treatment affect the prognosis of children with ARDS.