严重急性化学性肺水肿37例临床救治分析

Clinical Treatment of 37 Patients with Severe Acute Chemical Lung Edema

目的探讨严重急性化学性肺水肿的临床特点及其救治对策。方法选择江苏大学附属武进医院及中国人民解放军第306医院1995年以来救治的严重急性化学性肺水肿患者37例,回顾性分析患者的临床表现、诊断、治疗方法及死亡原因。结果本组37例中有3例患者死亡,病死率为8.2%。2例死亡者均有咳血性泡沫样痰、鼻腔流出泡沫状液体,肺通气换气功能严重损害,引起脑及心肌受损,出现呼吸循环衰竭、昏迷而死亡。34例患者经21条抢救处方治疗均痊愈。结论迟发性严重急性化学性肺水肿的危害特别大,因为初期不易引起急救医师的重视,一旦发病,病情危笃,使抢救措手不及。应对初期的严重性予以重视。

Objective To investigate the characteristics and clinical treatment of acute chemical lung edema induced by intoxication.Methods The clinical manifestations,diagnoses,treatments and death causes of 37 patients with severe acute chemical pulmonary edema treated in No 306 Hospital of PLA and Wujin Hospital since the year of 1995 were analyzed retrospectively.Results Three patients died,with a mortality of 8.2%,2 of whom had hemoptysis foamy sputum,spumescence fluid running out of nasal cavity,severely damaged pulmonary ventilation function,which caused brain and myocardial damage,repiratory circulatory failure,coma,and finally death.Conclusion The damage of severe tardive acute chemical pulmonary edema is especially great,because it is not so easy to draw physicians＇ attention in its early stage.Once it starts,the conditions are often critical,making rescue unprepared.Emphasis should be laid on its early severity.For patients,prevention is more important than treatment.