青藏公路高原肺水肿2303例现场急救分析

目的 探索高原肺水肿（HAPE）的现场救活方法，降低死亡率。方法 对2303例HAPE病例进行回顾性分析。结果 HAPE诊断准确率为90．17％，误诊率为9．83％，被误诊的疾病有：肺炎、心衰、风湿性心脏病、先天性心脏病，病毒性脑炎；死亡率：20世纪60年代为9．03％，70年代为6．88％，80年代为5．85％，90年代为3．52％，21世纪初为1．26％。氨荣碱、硝普钠、抗胆碱药、硝苯吡啶是治疗HAPE的有效药物，氨荼碱方案组的治疗优于硝普钠、654-2，P〈0．02、0．05。结论 HAPE发病的根本原因是缺氧，病情变化快，死亡率高；准确诊断，及时有效的给氧等治疗是抢救的关键。

Analysis of the Scene First Aid for 2303 HAPE Cases along the Tibet and Qinghai Road

Objective To explore the scene first aid for cases with high altitude pulmonary edema(HAPE) so as to reduce the mortality.Methods A retrospective analysis was made to 2303 cases with HAPE.Results The correct diagnosis rate of HAPE was 90.17% and misdiagnosis rate was 9.83%;the middiagnosis included pneumonia,heart failure,rheumatic heart disease,congenital heart disease,virul encephylitis;the mortality was 9.03%,6.88%,5.58%,3.52% and 1.26% respectively in 1960's,1970's,1980's and 1990's,in early 21th century,it was 1.26%.Among the effective drugs for HAPE:aminophylline,sodium nitroprusside,anticholiergic drug and nifedipine,aminophylline was the most effective.Conclusions The basic cause of HAPE is acute hypoxia.HAPE is of quick condition change,high mortality,so correct diagnosis and effective and immediate treatment are the key points in first aid.