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目的探讨持续静滴呋塞米预防围术期子痫前期相关性急性肺水肿的价值。方法选择2008年1月至2009年12月深圳市妇幼保健院产科ICU 68例重度子痫前期剖宫产患者,随机分为干预组(33例)和对照组(35例),对照组给予解痉治疗,干预组在此基础上于产后持续静滴呋塞米利尿治疗,比较两组手术前后、血氧饱和度、呼吸、心率、平均动脉压、围术期急性肺水肿发生率、D-二聚体及凝血功能等指标。结果干预组术后血氧饱和度(98.30±1.40)%与对照组术后(93.57±2.76)%相比,差异有统计学意义(P<0.05)。干预组术后平均动脉压(102.79±9.58)mmHg比对照组术后(117.06±8.20)mmHg明显下降,差异有统计学意义(P<0.05)。干预组围术期急性肺水肿的发生率为3.03%,明显低于对照组的19.44%,差异有统计学意义(P<0.05)。结论通过围术期子痫前期相关性急性肺水肿的干预治疗,可明显改善患者的肺功能和降低急性肺水肿的发生率,同时也有效地控制高血压。
Objective To investigate the value of continuous intravenous furosemide in preventing perioperative preeclampsia-related acute pulmonary edema. Methods 68 patients with severe preeclampsia from January 2008 to December 2009 in Shenzhen Maternal and Child Health Hospital were randomly divided into intervention group (n = 33) and control group (n = 35). The control group was given solution Spasm treatment, the intervention group on the basis of continuous infusion of furosemide in postpartum diuretic treatment, before and after surgery, oxygen saturation, respiration, heart rate, mean arterial pressure, perioperative acute pulmonary edema incidence, D- Dimer and coagulation and other indicators. Results The postoperative oxygen saturation (98.30 ± 1.40)% in the intervention group was significantly higher than that in the control group (93.57 ± 2.76)% (P <0.05). Mean arterial pressure (102.79 ± 9.58) mmHg in the intervention group was significantly lower than that in the control group (117.06 ± 8.20) mmHg, the difference was statistically significant (P <0.05). The incidence of perioperative acute pulmonary edema was 3.03% in the intervention group, which was significantly lower than that in the control group (19.44%), the difference was statistically significant (P <0.05). Conclusion Interventional treatment of acute pulmonary edema associated with perioperative preeclampsia can significantly improve the patient’s lung function and reduce the incidence of acute pulmonary edema, as well as effectively control hypertension.