47例非心原性肺水肿的诊治体会

目的：为提高对非心源性肺水肿的认识与诊治能力。方法：选择近十年来符合非心原性肺水肿临床表现的病例进行回顾性总结分析；结果：计47例，男22例，女25例，年龄7～80岁，平均36.9岁。47例患者可分11类20多种疾病，包括：复张后肺水肿5例，吸入性肺水肿5例，中毒后肺水肿9例。脑源性肺水肿5例，静脉淤血综合症3例，结缔组织疾病并发急性肺水肿4例，尿毒症性肺水肿3例，严重肺部感染所致肺水肿8例，肿瘤及抗肿瘤治疗所致肺水肿3例，脂肪栓塞所致ARDS1例，妊娠中毒征所致急性肺水肿1例。其中发生2次肺水肿者6例，发生ARDS者7例；死亡／未愈者计24例，占50.06％。结论：NCPE的基础疾病甚多，涉及临床内、外、妇产科、传染、肿瘤等各科，诱发NCPE的诱因也众多，既有医源性的，更多的是各种不同的致病因素，包括物理的、化学的、毒物性的、细菌性和肿瘤等多种因素。NCPE与ARDS有密切联系，及时诊断和处理NCPE的发生和发展，有利于对ARDS的防治.

Experience of diagnosis and treatmant on non cardiogenic acute pulmonary edema

Objective: To improve recognition and ability of diagnosis and treatment for non cardiogenic acute pulmonary edema (NCPE). Methods: The cases suffered from NCPE in the past ten years were analysed and sumed. retrospectively. Results: It totaled 47 cases of NCPE, 22 male,25 famale,the age was from7 to 80 years oid, mean age 36.9 years, the patients may be divided into 11 groups over 20 kinds of diseases, it included 5 cases of re-expantion pulmonary edama (RPE), 5 aspiration pulmonary edema, 9 toxic pulmonary edema, 5 cerebrocentric pulmonary edema ,3 venous stasis of blood syndrome, 4 connective tissues diseases with acute pulmonary edema ,3 uraemigenic pulmonary edema, 8 serious pulmonary infection causing pulmonary edema, 3 pulmonary edema induced by tumor and anti-tumor therapy,1 ARDS owing fat embolizetion,and 1 pregnant toxin causing acute pulmonary edema. In which 6 cases of patients suffered from twice acute pulmonary edema,7 cases advanced to ARDS,death and deterioration were 24 cases,(50.06%).Conclusion: Bisic disorders of NCPE are various diseases of internal medicine,surgical ,gynaecology and obstetrics,infect and tumor ect. Causative factors of NCPE have not only some medical of source but also all kinds of pathogeny , it is physical , chemical , poisonous substance and toxin, bacterium and tumor and so on. NCPE has a direct bearing on ARDS,diagnosis and treatment of NCPE without delay,it should be favourable to prevention and treatment of ARDS.