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一、定义Clark(1977)认为急性重症哮喘的定义是,‘哮喘的严重发作,对常规以上的治疗没有反应’,这实际上与‘渐进性气道阻塞’同义。而作者认为,‘急性重症哮喘’与‘渐进性气道阻塞’是完全不同的两种病理生理过程,是应该加以区别的两种临床情况。急性重症哮喘的标志是循环障碍,从心动过速、奇脉到低血压和循环衰竭。这些都是原发障碍,而不是由于低氧血症引起的继发障碍。理由是:(1)有两组气道阻塞程度类似的哮喘患者,渐进性气道阻塞组的患者虽有呼吸困难,但心率正常,能维持日常事务,而急性重症哮喘组患者却有十分危重的循环障碍;(2)Rees等人(1967)详细观察了25例急性
I. DEFINITIONS Clark (1977) defines acute severe asthma as “a serious attack of asthma that does not respond to more than conventional treatment,” which is actually synonymous with ’progressive airway obstruction.’ The author believes that ’acute severe asthma’ and ’progressive airway obstruction’ are two completely different pathophysiological processes, which should be distinguished from the two clinical situations. Signs of acute severe asthma are circulatory disturbances, from tachycardia, kiwi to hypotension and circulatory failure. These are primary disorders, not secondary disorders due to hypoxemia. The reasons are: (1) There are two groups of asthma patients with similar degree of obstruction of airway. Although patients with progressive airway obstruction group have dyspnea, their heart rate is normal, their daily affairs can be maintained, whereas patients with acute severe asthma group are in critical condition Of circulatory disorders; (2) Rees et al. (1967) examined in detail 25 acute cases