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我院近10年来应用20%甘露醇积极脱水、大剂量呼吸兴奋剂及人工通气,抢救乙脑呼衰病人105例,死亡35例,病死率33.33%。我们的体会:(1)本组第7病日后发生呼衰者43例,占40.95%。体温38℃以下发生呼衰者68例,占64.76%,其中17例低于37℃可见部分病人体温虽降而脑部病变仍在进展。(2)近年来发现急性呼衰时肺含水量增加,肺水肿原因可能与炎症和缺氧引起肺毛细血管渗透性改变有关。本组病人临床出现肺水肿4例,死亡2例,应引起重视。
Nearly 10 years, our hospital applied 20% mannitol active dehydration, high-dose respiratory stimulants and artificial ventilation, rescuing 105 cases of Japanese B patients with respiratory failure, 35 deaths, the fatality rate was 33.33%. Our experience: (1) in this group of patients with respiratory failure occurred in the first 7 cases of 43 cases, accounting for 40.95%. 68 cases of respiratory failure occurred below 38 ℃, accounting for 64.76%, of which 17 cases were below 37 ℃, although some patients showed decreased body temperature and brain lesions are still progressing. (2) In recent years, when acute respiratory failure was found, the lung water content increased. The cause of pulmonary edema may be related to the change of pulmonary capillary permeability caused by inflammation and hypoxia. In this group of patients, 4 cases of pulmonary edema and 2 died, should pay attention.