论文部分内容阅读
目的探讨颅脑损伤后神经源性肺水肿患者的诊断及治疗要点。方法回顾分析1996年10月以来收治的一组脑外伤后神经源性肺水肿患者临床资料。结果本组患者存活14例,其中8例患者苏醒,遗留部分神经功能障碍,4例重残,2例呈植物生存状态。死亡18例,其中10例死于顽固性缺氧及呼吸衰竭,8例死于晚期脑疝,死亡率为56.25%。结论神经源性肺水肿是严重危害患者生命的脑外伤后并发症。临床以急性进行性呼吸困难和难以纠正的低氧血症为特点,尽早行血气分析检查有助于诊断,治疗要点包括:(1)有效降低颅内压,保护脑功能;(2)保持呼吸道通畅,如吸氧已不能纠正缺氧状态,尽早使用呼吸机机械通气:(3)应用血管扩张剂,减轻肺循环负荷,减轻肺水肿(4)早期应用激素可提高机体应激能力,减轻脑水肿和肺水肿(5)控制肺部感染(6)保持水、电、酸碱平衡,维持有效液循环和组织供氧。
Objective To investigate the diagnosis and treatment of neurogenic pulmonary edema after craniocerebral injury. Methods The clinical data of a group of patients with neurogenic pulmonary edema after traumatic brain injury treated since October 1996 were retrospectively analyzed. Results The group of patients survived in 14 cases, of which 8 patients recovered, left some neurological dysfunction, 4 cases of severe disability, 2 cases were plant survival status. Eighteen died, of which 10 died of intractable hypoxia and respiratory failure, 8 died of late hernia, the mortality rate was 56.25%. Conclusion Neurogenic pulmonary edema is a post-traumatic brain injury complication that seriously affects the life of patients. Clinical features of acute progressive dyspnea and difficult to correct hypoxemia as the characteristics of blood gas analysis as early as possible to help diagnose the diagnosis, treatment points include: (1) effectively reduce intracranial pressure, protect brain function; (2) to maintain the respiratory tract Unobstructed, such as oxygen can not correct hypoxia, as soon as possible the use of ventilator mechanical ventilation: (3) the use of vasodilators, reduce pulmonary circulation load, reduce pulmonary edema (4) early application of hormones can improve the body’s stress ability, reduce cerebral edema And pulmonary edema (5) control of lung infection (6) to maintain water, electricity, acid-base balance, maintain effective fluid circulation and tissue oxygen supply.