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一、低氧性肺水肿的病理生理低氧造成的肺水肿,文献上最早记载的是高原性肺水肿,但临床上通常认为因海洛英过量、窒息、脑外伤及高心输出量并发缺氧的病理情况下,都可发生肺水肿。Severingghaus教授认为,此时漏到血管外的水分并不象人们一般认识经过毛细血管的途径,而是在低氧所致肺动脉高压基础上,经肺动脉壁漏出,其理由如下:(1)高原性肺水肿患者与高原居民一样,对缺氧所引起的肺动脉血压反应要比正常人明显地增高。(2)肺的大动脉管壁薄而伸展性强,当肺动脉压超过正常20mmHg时,其血管口径可扩大一半。(3)高原性
First, the pathophysiology of hypoxic pulmonary edema Pulmonary edema caused by hypoxia, the earliest documented in the literature is high altitude pulmonary edema, but clinically it is generally considered due to excessive heroin, asphyxia, traumatic brain injury and high cardiac output concurrency Pulmonary edema can occur in the pathological conditions of oxygen. Professor Severingghaus believes that at this time the leakage into the extravascular water is not as common as people through the capillary pathway, but in hypoxia caused by pulmonary hypertension, pulmonary artery wall leakage for the following reasons: (1) high altitude Patients with pulmonary edema, like plateau residents, have significantly higher pulmonary arterial pressure responses to hypoxia than normal controls. (2) The aortic wall of the lung is thin and extensible. When the pulmonary arterial pressure exceeds the normal 20 mmHg, its blood vessel caliber can be enlarged by half. (3) high altitude