重度子痫前期/子痫合并急性呼吸窘迫综合征的诊断与处理

目的 探讨重度子痫前期／子痫合并急性呼吸窘迫综合征（acute respiratory distress syndrome，ARDS）原因、早期诊断与处理。方法 回顾性分析2003年1月至2005年1月治疗的5例重度子痫前期／子痫合并ARDS临床资料。结果 本院同期重度子痫前期／子痫患者60例，合并ARDS者5例，发生率8.3％，5例中4例有严重的合并症。ARDS均表现为急性起病，呼吸频数，氧合指数PaO2／FiO2≤〈200mmHg，胸片示双肺浸润影。ARDS均在控制重度子痫前期／子痫的同时，使用以无创呼吸机呼气末正压（PEEP）通气吸氧为主的综合治疗，获得治愈。结论 重度子痫前期／子痫患者较易并发ARDS，一旦病人呼吸改变或血气异常，应警惕ARDS，治疗关键在于及早应用机械辅助呼气末正压通气（PEEP）吸氧为主的综合治疗。

The diagnosis and management of preeclampsia/eclampsia complicated by acute respiratory distress syndrom(ARDS)-5 cases report

Objective To study the causes,early diagnoses and treatment of patients with preeclampsia/eclampsia complicated acute respiratory distress syndrome(ARDS).Mothods from Jan 2003 to Jan 2005,a total of 5 patients with preeclampsia/eclampsia complicated ARDS were reviewed retrospectively.Results 4 in 5 patients have severe complications.they all showed acute onset,tachypnea,bilateral infiltrates on chest x-ray and the index of oxygenation PaO_2 /FiO_2 less than 200mmHg.ARDS was treated with comprehensive management leading by inspiring oxygen with pressure support ventilation by non invasive ventilator with a positive-end expiratory pressure(PEEP),At the same time,preeclampsia/eclampsia was treated.all patients have good outcome.Conclusions ARDS occurs more frequently in patients with preeclampsia/eclampsia,once patients show tachypnea and abnormal arterial blood gas,ARDS should be attentioned.the key treatment is comprehensive management leading by inspiring oxygen with pressure support ventilation by non invasive ventilator with a positive-end expiratory pressure(PEEP)should be used earlier.