围产期急性心源性肺水肿11分析

Rescue of perlnatal acute cardiogenic pulmonary ede- ma: Clinical analysis or 11 cases.

通过对１１例围产期急性心源性肺水肿（ＰＡＣＰＥ）抢救成功的回顾性分析，着重指出动脉血气分析监测有助于判断病情，指导治疗和观察疗效。对危重的ＰＡＣＰＥ应用呼吸机面罩加压给氧或呼气末正压通气，可迅速改善肺水肿、缺氧和高碳酸血症以及胎儿窘迫，静滴硝酸甘油可迅速减少回心血量，大剂量静滴可扩张小动脉，降低血压，也适用于如高征ＰＡＣＰＥ，副作用少．血液动力学监测简单。纳洛酮可解除吗啡对婴儿出生时的呼吸抑制。

bjective:To determine the value of arterial blood gasanalysis, positive pressure of oxygen inspiration byrespiratory mask,positive pressure ventilation at expiratory end and intravenous drip with nitroglycerin forrescue of perinatal acute cardiogenic pulmonary edema(PACPE). Design: 11 cases with PACPE treated between 1986 to 1993 at our hospital were reviewed. Results:All the patients were rescued successfully. Conclusion:Arterial blood gas analysis is of benefit to detemine the patient's condition, direct the treatmentand observe therapeutic effects. positive pressure ofoxygen inspiration by respiratory mask and positivepressure ventilation at expiratory end can rapidly improve fetal hypoxemia with hypercapnia and fetal intrauterine distress. Large dose of nitroglycerin can decrease blood pessure and can be used on PIH withPACPE.