尿毒症性急性肺水肿——附32例报告

本文报告32例尿毒症性急性肺水肿。慢性肾功能衰竭患者,尤其在少尿或无尿期,突然发生严重呼吸困难、端坐呼吸、咳嗽、咯痰(典型者咯出大量粉红色泡沫状痰)、咯血、双肺对称性布满湿性罗音及哮鸣音、心率超过100次/分、脉搏细弱、血压显著升高或休克,可认为发生急性肺水肿。代谢废物潴留、酸中毒、高血压、贫血、感染都可影响心脏功能,诱发和/或加重急性肺水肿。尿毒症性急性肺水肿的治疗包括严格限制钠、水摄入,应用大剂量利尿剂、小剂量强心甙制剂及/或血管扩张剂、以及透析疗法。

ACUTE PULMONARY EDEMA IN UREMIA——A report of 32 cases

In this article, 32 cases of uremic acute pulmonary edema were reported. In patients with chronic renal failure, especially during oliguria or anuria, when severe dyspnea, orthopnea, cough, sputum(often producing large amounts of characteristic pink frothy sputum), hemoptysis, bubbling rale and wheezing in lungs, heart rate above 100 beats/Min, pulse fine and weak, striking elevated blood pressure or shock suddenly occur, acute pulmonary edema should be considered. The retention of waste products, acidosis, hypertention, anemia, and infection all may affect cardiac function, resulting in and/or accelerating acute pulmonary edema.The treatments of uremic acute pulmonary edema include limiting Na~+ and water severely and giving large amounts of diuretic egents, small amounts of digitalis and/or general vasodilatation agents, and dialysis.