ICU内肺高压的治疗进展  

Research progress on pulmonary hypertension in the intensive care unit

作　　者：左祥荣(综述)[1] 曹权[1] 王虹(审校)[2] 

机构地区：[1]南京医科大学第一附属医院ICU,210029 [2]南京医科大学第一附属医院呼吸内科,210029

出　　处：《中国急救医学》2011年第1期71-74,共4页Chinese Journal of Critical Care Medicine

基　　金：江苏省卫生厅科教兴卫工程重点学科开放课题（No.XK13200902）;江苏省教育厅项目（No.JH08-10）

摘　　要：肺高压可由多种疾病引起,在ICU内比较常见,明显影响危重病患者的预后.ICU医师要高度重视和早期识别危急重症情况下的肺高压和右心衰竭.治疗上必须首先找到并解决引起肺高压的原发因素 其次,对于严重急性肺高压应通过选择性肺血管扩张剂和正性肌力药物降低肺血管阻力,尽快减轻右心室后负荷,防止或逆转右心功能障碍 对于并发右心衰竭和体循环低血压的危重肺高压,需要进行严密的血流动力学监测和积极联合选择性肺血管扩张剂、升压药物和正性肌力药物治疗.Pulmonary hypertension may be cause by many medical conditions and is commonly encountered in the intensive care unit, significantly affect survival of critically ill patients. Intensivists should attached great importance to early recognition of severe cases of pulmonary hypertension and right heart failure in critical conditions. To determine appropriate therapy, the approach to patients with pulmonary hypertension in the ICU must begin with identification and treatment of the underlying cause. Then, therapy of Severe acute pulmonary hypertension should generally be aimed at acutely relieving right ventricular pressure overload and preventing right heart dysfunction by decreasing pulmonary vascular resistance and preventing or reversing right heart dysfunction with pulmonary vasodilators and inotropes. Critically ill patients with severe pulmonary hypertension complicated by right heart failure and systemic arterial hypotension are real clinical challenges requiring tight hemodynamic monitoring and aggressive treatment including combinations of selective pulmonary vasodilators, vasopressors and inotropes.

关 键 词：肺高压 重症监护病房 右心衰竭 

分 类 号：R654.1[医药卫生—外科学]