6例高原肺水肿继发ARDS的临床治疗分析

目的 研究分析高原肺水肿(HAPE)继发急性呼吸窘迫综合征(ARDS)的治疗方法及氧动力学变化特点.方法 对6例HAPE继发ARDS患者进行了机械通气、药物治疗及氧动力学监测.结果 6例患者经1 w治疗后,发绀明显好转,PaO2、SaO2、PaO2/FiO2较1 w前显著升高(P＜0.01).结论 对HAPE经常规治疗1 w左右不见好转的,应高度警惕并发症的发生.HAPE继发ARDS时,氧动力学已发生明显紊乱,病情危重,治疗的关键是早期机械通气,改善组织氧合,限制入量,同时予药物治疗.

Clinical analysis of treatment of secondary acute respiratory distress syndrome induced by high altitude pulmonary edema in 6 cases

Objective To analyze the treatment method and oxygen dynamics changes of secondary acute respiratory distress syndrome(ARDS) induced by high altitude pulmonary edema(HAPD).Methods Six patients with secondary ARDS induced by HAPD received mechanical ventilation,drug treatment,and oxygen dynamics monitoring.Results After 1 w of treatment,the cyanosis of these patients was significantly improved,and the levels of PaO2,SaO2,and PaO2/FiO2 significantly increased(P<0.05 or P<0.01).Conclusion If the condition of patients with HAPE is not improved after 1 w of conventional treatment,it is necessary to vigilance for the occurrence of complications.In patient with HAPE and secondary ARDS,their oxygen dynamics is disorder and the conditions are severe.The key for the treatment is the early use of mechanical ventilation,improvement of the oxygenation of organs,restriction of the input volume of liquid,and medication at the same time.