全麻期间并发急性肺水肿(附5例报告)

目的　探讨全麻期间急性肺水肿的发病、诊断、治疗和预后。方法　临床资料的回顾性分析。结果　全身麻醉期间发生急性肺水肿5例，发病机理可能为心源性肺水肿、负压性肺水肿和通透性肺水肿。预防及处理意见是①严格控制输血输液量；②有胸水的病人在抽胸水时，首次量应控制在800ml左右；③胸科手术中，特别是双侧开胸手术者，避免单肺通气或对肺组织挤压、牵拉时间过长。结论　急性肺水肿是全身麻醉的严重并发症，须及时诊断和治疗

Acute pulmonary edema during general anesthasia.

Objective To study the clinical feature,diagnosis,treatment andprognosis of acute pulmonary edema during general anesthasia.Methods The clinical material are retrospectively analysed.Results 5 cases Acute pulmonary edema are onset during general anesthasia.The provocation must possible was cardiogenic pulmonary edema,negative-pressure pulmonary edema and permeability pulmonary edema.The opinion of prevention and treatment was:①To control both transfusion volume of fluid and blood;②When you drew pleural fluid,for the patients with pleural fluid,the first volume have to control in 800 ml;③In thoracic surgery particular in both chest,you have to avoid one lung ventilation to much time and crushed or drag the lung tissues to much.Conclusion Acute pulmonary edema was the severity complication during general anesthasia.We have to diagnosis and treatment in time.