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目的探讨癫癎持续状态合并神经源性肺水肿(neurogenicpulmonaryedema,NPE)的发生机制、诊断及治疗,提高癫癎持续状态并发NPE的治愈率。方法总结癫癎持续状态合并NPE的16例患者的临床表现,辅助检查的特征及治疗经过。其中9例比较了治疗前、治疗后的血流动力学参数及氧合指数(PaO2/FiO2)。结果NPE患者治疗前肺动脉楔压(PAWP)、PaO2/FiO2低于正常。治疗后PAWP显著下降,PaO2/FiO2迅速好转。14例患者经积极治疗后痊愈,1例自动出院,1死亡。结论癫癎持续状态合并NPE的早期诊断、正确的治疗方案的制定,是提高其治愈率的关键。
Objective To investigate the mechanism, diagnosis and treatment of persistent epilepsy with neurogenic pulmonary edema (NPE) and to improve the cure rate of persistent NPE with epilepsy. Methods The clinical manifestations, the features of auxiliary examinations and the course of treatment were reviewed in 16 patients with persistent status epilepticus and NPE. Nine of them compared the hemodynamic parameters and oxygenation index (PaO2 / FiO2) before and after treatment. Results Pulmonary arterial wedge pressure (PAWP) and PaO2 / FiO2 in NPE patients before treatment were lower than normal. PAWP decreased significantly after treatment, PaO2 / FiO2 rapidly improved. 14 patients recovered after active treatment, 1 patient was discharged automatically and 1 died. Conclusion Early diagnosis of epileptic seizure combined with NPE, the correct treatment plan is to improve the cure rate of the key.