21例麻醉期间急性肺水肿的诊治分析

目的探讨麻醉期间急性肺水肿发生的原因和诊治措施.方法总结我科近年来21例不同病种病人麻醉手术期间急性肺水肿的临床资料,并对其发生原因以及诊治措施进行分析.结果所有病人均出现心率增快、脉搏氧饱和度下降,双肺听诊满布湿罗音和哮鸣音.气管插管全麻病人气道阻力明显增加,8例病人有粉红色泡沫痰从气管导管溢出.非气管插管全麻病人均出现烦躁和呼吸困难,经抢救插管后4例病人可见粉红色泡沫痰从气管导管溢出.部分病人出现代谢性酸中毒和低氧血症.结论麻醉手术期间急性肺水肿发生突然,病情变化快,快速正确的诊断和有针对性的治疗措施是挽救病人生命的关键.

Diagnosis and treatment of acute pulmonary edema during anesthesia

Objective To explore the causes,diagnosis and treatment of acute pulmonary edema during anesthesia by retrospective analysis of 21 cases.Methods Clinical data of 21 cases of acute pulmonary edema were summarized by analysizing etiology,diagnosis and treatment during anesthesia.Results Tachycardia,decline of SPO2 and rale of lung was found in all patients.Increase of airway pressure was found in those patients who underwent general anesthesia, overflow of forthy and bloody sputum in tracheal tube was found in 8 patients.Other patients who underwent non-general anesthesia appeared fidget and dyspnea,4 patients appeared frothy and bloody sputum in tracheal tube after emergent intubation.Some patients appeared metabolic acidosis and anoxemia.Conclusions Acute pulmonary edema happens and changes rapidly during anesthesia.So accurate diagnosis and subsequent treatment based on diagnosis are pivotal facters affecting prognosis of patients.