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目的 评价氧疗在高原肺水肿治疗中的作用。 方法 采用右心漂浮导管检测法 ,观察了 8例高原肺水肿患者吸入纯氧及突然停止吸氧对患者肺动脉的影响 ,同时采用 L ake L ouise评分法对患者的病情进行定量评估。 结果 高原肺水肿患者肺动脉平均压在吸氧 1min后逐渐明显下降 ,患者在突然停止吸氧而改吸室内空气后 ,下降的肺动脉压逐渐回升 ,10 m in后回复到吸氧前水平 ,但随着时间的延长 ,肺动脉压继续攀升 ,2 0 m in后肺动脉压已明显高于吸氧前水平 ,2 5 min后肺动脉压达最高值 ,与此同时 ,高原肺水肿患者病情定量分数亦显著高于吸氧前。 结论 高原肺水肿患者存在着再缺氧损伤 ,而肺动脉压异常升高在其发生中起重要作用。
Objective To evaluate the role of oxygen therapy in the treatment of high altitude pulmonary edema. Methods Right heart floating catheter detection method was used to observe the effects of inhaled pure oxygen and sudden stop of oxygenation on pulmonary artery in 8 patients with pulmonary edema in the plateau. Meanwhile, L ake L ouise scoring method was used to evaluate the patients’ condition. Results The mean pulmonary artery pressure in patients with high altitude pulmonary edema decreased gradually after 1 min of oxygen inhalation. The patient’s pulmonary pressure decreased gradually after oxygen inhalation was stopped and the air in the chamber was resorbed. After 10 min, the pulmonary pressure returned to the level before oxygen inhalation, With prolongation of time, the pulmonary pressure continued to rise. The pulmonary arterial pressure after 20 min was significantly higher than that before oxygen inhalation, and the peak pulmonary arterial pressure reached the peak at 25 min. At the same time, the quantitative score of the patients with high altitude pulmonary edema was also significantly higher Before oxygen. Conclusion There is hypoxia injury in patients with plateau pulmonary edema, and abnormal pulmonary hypertension plays an important role in its occurrence.