摘要
目的 观察特高海拔地区现场高压氧 (HBO)治疗对高原肺水肿 (HAPE)病人肺动脉压的影响 ;评价HBO对HAPE的疗效 ;探讨肺动脉高压 (PH)与HAPE的关系 ;强调现场就地治疗的重要性。方法 在 4636米特高海拔 (气压 5 7.41kPa,氧分压 1 2 .OkPa)现场治疗来自海拔 4636～ 5 1 30米 (气压5 7.41～ 5 3.2 8kPa/431 .6～ 40 0 .6mmHg,氧分压 1 2 .0～ 1 1 .6kPa/90 .0～ 87.0mmHg)的HAPE 32例。治疗前后对其临床症状、X光胸片、血氧饱和度 (SaO2 )、平均肺动脉压 (MPAP)进行自身对照。结果 治疗前后 32例HAPE临床症状、体征及MPAP等各项观测指标显著改善 ,P <0 .0 0 1。结论 特高海拔现场HBO救治HAPE效果肯定 ,它能使显著增高的肺动脉压降低 ,全部病例病情迅速改善 ,其中 1 1例 ( 34.3% )基本治愈。为下送进一步治疗创造了条件。HAPE患者均有PH ,而PH者未必一定发生HAPE ;PH是机体适应缺氧环境的正常代偿 。
Objective To observe the impact of pulmonary -artery pressure, evaluate the treatment effect of HAPE with HBO on the spot of extreme altitude. And to explore the relationship between pulmonary hypertension (PH) and HAPE, emphasize the importance of thetreatment on the spot. Methods The 32 patients from the Plateau of 4 636～5 130m (barometric pressure: 57.41 ～ 53.28 kPa/431.6～400.6 mmHg , Partia pressure of oxygen: 12.0～11.6kPa /90.0～8.0mmHg ) were treated on the spot of 4 636m altitude with HBO. Before and after the treatment, the clinical symptoms/ signs, radiographic evidence, SaO 2, MPAP were compared. Results The clinical symptoms/signs, and all the targets of the patients were improved dramatically,P<0.001. Conclusion To treat HAPE with HBO is the most effective method among various therapy on the spot of extreme altitude, improved promptly .Among the subjects, 11 cases(34.3%) were cured at once. It makes possible for further treatment on lower altitude area. We suggest it should be the first choice on the spot. And there are must be PH in the patients of HAPE. But it is not the true oppositely. The PH is a mechanism of normal compensation of the body when it is exposure in hypoxic environment. It is very necessary for us to explore the threshold of HAPE when a PH exists.
出处
《青海医学院学报》
CAS
2004年第4期301-304,共4页
Journal of Qinghai Medical College
关键词
高压氧
高原肺水肿
肺动脉高压
就地治疗
Hyperbaric Oxygenation (HBO) High Altitude Pulmonary Edema(HAPE) Pulmonary Hypertension (PH) Treatment on the spot.
