海洛英中毒并急性肺水肿的特点和救治

The Patterns of Presentation and Treatment in Heroin Overdose Resulting in Pulmonary Edema

目的:探讨海洛因中毒并急性肺水肿的临床特点及有效抢救方法。方法:回顾性分析我院自1990-2003年收治的15例海洛因中毒并急性肺水肿临床资料。结果:15例患者均以昏迷、呼吸抑制、针尖样瞳孔以及双肺布满湿罗音为主要特征,血气分析呈低氧血症、高碳酸血症和酸中毒,胸片显示急性肺水肿改变,经通气,使用纳络酮等综合治疗后,抢救成功13例,占86.6％,死亡占13.4％。结论:海洛因中毒并急性肺水肿,病情凶险,进展迅速,但经恰当治疗,病情是可逆的;早期、足量、持续使用纳络酮是抢救成功的关键。

Objective:To study the clinical presentation and the effective treatment of heroin overdose induced noncardiogenic pulmonary edema(NCPE). Method: A retrospective chart review of 15 patients presenting between 1990 and 2003 with the heroin overdose (HOD) was conducted. Results; All characteristic of 15 cases were coma, respiratory depression and rales throughout both lung fields. Blood gases show hypoxia, academia and/or hypercapnia. Radiographic characteristic is pulmonary edema. To treat with naloxone and supplemental oxygen or mechanical ventilation, 13 of 15 patients (86.6%) were alive. The mortality was 13.4%. Conclusion: Although NCPE is a severe complication of heroin overdose. It can be reversible, if giving the proper treatment. Early, enough and continual using naloxone is a crucial treatment.