高原肺心病极重度呼吸衰竭并发多器官衰竭的救治

对６２例ＰａＯ＿２＜４．００ｋＰａ（３０．０ｍｍＨｇ）的高原肺心病极重度呼吸衰竭并发多器官衰竭患者采用了抗感染、通畅气道、利尿、强心、吸入２９％～３５％氧、呼吸兴奋剂、糖皮质激素、降低血粘度等措施救治，救治成功率８８．７％，病死率１１．３％。作者认为采用本方法救治２４ｈ后，若患者ＰａＯ＿２能提高到５．３３ｋＰａ（４０．１Ｈｇ）以上，则基本可救治成功，若ＰａＯ＿２仍小于４．００ｋＰａ（＜３０．０ｍｍＨｇ），则应尽早行机械通气。作者对其救治中的氧疗及降血粘度治疗等诸问题进行了讨论。

Emergency trea tment of extremely severe respiratoryhilure and associa ted mutiple organ failure due to highaltitude cor puimonale

62 patients with extremely severe respiratoryfailure and associated multiple organ failure due tohigh altitude cor pulmonale(PaO_2<4.0kPa)weretreated.The treatments included anti-infectives,diuretics,cardiac tonics,respiratory stim ulants,glucocorticoids,oxygen inhalation,airway-clearingand decreasing the blood viscosity.The rate of suc-cess was 88.7%and the mortality was11.3%.D espiteof the existence of respiratory failure and MOF,the.emergency treatments were mostly successfulifPaO_2 could be increased to more than 5.3kPa after24 hours of treatment If.however,PaO_2 remained tobe lower than 4.0kPa,mechanical ventilation shouldbe em ployed as early as possible,Issues of treatmentssuch as oxygen therapy and methods of decreasingthe blood viscosity were discussed.