吸入低浓度一氧化氮治疗高原肺水肿甲襞微循环动态观察  

CHANGES OF MICROCIRCULATION OF NAILBED DURING NO TREATMENT OF HAPE

作　　者：李朝斌[1] 张西洲[1] 陈占诗[1] 王伟[1] 崔建华[1] 张素萍[1] 陈秀山[1] 刘宁[1] 

机构地区：[1]新疆解放军第18医院,844900

出　　处：《高原医学杂志》2000年第1期19-21,共3页Journal of High Altitude Medicine

基　　金：全军医药卫生科研基金资助

摘　　要：探讨吸入低浓度一氧化氮 (NO)治疗高原肺水肿甲襞微循环的变化与机理 ;方法 :12例高原肺水肿患者 ,在常规治疗基础上吸入浓度为 10× 10 - 6 NO 30分钟 ,用WX -6型微循环显微仪观察高原肺水肿NO治疗前、治疗 45分钟和治愈后甲襞微循环变化 ;结果 :治疗前与治疗 45分钟及治愈后比较 ,甲襞毛细血管管袢输入枝缩小 ,输出枝管经和袢顶增宽 ,A/V比例失调 ,血流变慢呈粒流和粒缓流 (占 83% ) ,伴RBC聚集和袢渗出 (占 6 7% ) ,毛细血管形态 ,血液流态和袢周状态加权积分值和总积分值增大 ,统计学处P <0 .0 5～P <0 .0 0 1)。治疗 45分钟与治愈后比较 ,管袢数、输入枝管径和管形态加权积分值无明显变化 (P <0 .0 5 ) ,其它各项变化显著 (P <0 .0 1～P <0 .0 0 1)。Hb显著高于治疗 45分和治愈后 (P <0 .0 0 1) ,治愈后又高于治疗 45分时 (P <0 .0 5 )。结论 :吸入低浓变NO对急性缺氧性肺动脉高压有非常显著的降压作用 ,对救治高原肺水肿起重要作用 ,通过迅速纠正低血氧症而改变甲襞微循环。To study changes of microcirculation of nailbed during NO treatment of high altitude pulmonary edema(HAPE).Methods:The microcirculation of nailbed in 12 cases with HAPE,who had treated generally,were observed using wx-6 microcirculation microscpy pre,in 45′ and after low concentration NO aspiring theropy.Results:The diameter of afferent loop branch was lessen but widen efferent branch,A/V ratio was disorder and the blood flow was so slow that RBC was seriously aggregation and peripheral exudation before NO treatment.All index but the number of loop,diameter and form of the afferent branch were changed significantly (P<0.01～P<0.001).Conclusions:The reducing effects of NO on pulonary hypertension were remarkable and could treat HAPE.

关 键 词：高原肺水肿 HAPE 一氧化氮 甲襞 微循环 

分 类 号：R594.3[医药卫生—内科学]