高原肺心病极重度呼吸衰竭并发多器官衰竭的救治  

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

作　　者：杨生岳[1] 马子琪[1] 冯恩志[1] 张志强 

机构地区：[1]解放军第4医院

出　　处：《中国危重病急救医学》1994年第5期261-263,共3页Chinese Critical Care Medicine

摘　　要：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。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.

关 键 词：肺心病 并发症 高原 呼吸衰竭 多器官衰竭 

分 类 号：R541.906[医药卫生—心血管疾病]