体外循环中急性肺水肿分析

Analysis the acute pulmonary edema in extracorporeal circulation

目的:强调重视和加强体外循环中对肺功能的保护。方法:分析16例在体外循环中发生肺水肿患者术前的肺动脉高压、血红蛋白、肾功能和心功能情况。经PEEP+利尿药+激素和超滤器为主,辅以强心、扩血管药的协同治疗。结果:所有患者经治疗后气道阻力下降,均减小至术前水平。无酸中毒,尿量>100ml/min.平均2.5天拔管停呼吸机,11例患者术后第一天均顺利脱离呼吸机。15例患者出院,1例死于MOF。结论:中度肺动脉高压、贫血和心肾功能功能不全可能是体外循环中急性肺水肿的诱发因素。体外循环时应采取措施预防和减轻肺功能损伤。

Objective: To emphasize the importance of lung function protection in extracorporeal circulation. Methods: We analysised the preoperative pulmonary artery hypertension, hemoglobin, renal function and heart function of 16 patients who had pulmonary edema in extracorporeal circulation. The chief treatment was PEEP + diuretic + hormone and ultrafiltration,assisting cardiac tonic and vasodilator. Results:After treated all patients' resistance of airway was decreased to the preoperative level,no one had acidosis. Urine volume of anyone exceeded 100 ml/min. 11 patients was favorably concluded assisted respiration inly after one day, and average 2.5 days postoperation all patients was concluded that. 15 patients were discharge, 1 patient dead for MOF. Conclusion: Moderate pulmonary artery hypertension, anemia,cardiac insufficiency and renal insufficiency may be the inducement of acute pulmonary edema in extracorporeal circulation. So we should do something to defend and lighten the injury of lung function in extracorporeal circulation.