摘要
目的:探讨重症肺动脉高压患者终末期临床特点及救治策略。方法:回顾性分析2000至2004期间我院肺动脉高压死亡患者19例的临床表现及治疗经过。结果:12例患者末次住院诱因为肺部感染。19例患者肺动脉收缩压平均(100.6±20.2)mm Hg(1 mm Hg=0.133 Kpa),右心室内径与左心室内径之比(RV/LV)为1.12±0.52。死亡前诱发因素主要为大便用力(42.1%)和突然的体位改变(10.5%);死亡前呼吸频率及心率明显加快,超声心动图检查示右心室较入院时进一步扩大。分析患者直接死亡原因,10例为心源性休克(52.6%),6例为急性肺水肿(31.6%),2例为失血性休克(10.5%),1例为呼吸衰竭(5.2%)。结论:重症肺动脉高压尤其是心室内径之比RV/LV>1.0预后差,常在使心率加快、回心血量骤然减少等诱发因素下,启动急性肺水肿和心源性休克抢救,无效死亡。目前尚无明确有效的抢救措施。因此,应当积极预防和控制各项诱发因素,尝试不同给药途径合理应用血管活性药物进行救治。
Objective ： To summarize the clinical features and treatment of severe pulmonary hypertension patients. Methods： Clinical symptoms and treatment of 19 patients were analyzed retrospectively,who died from sever pulmonary hypertension from 2000 to 2004 in our hospital. Results： Average pulmonary artery, pressure of all patients was 100. 6±20. 2 mmHg, and the average ratio of right to left ventricular diameter was（1.12±0. 52）. 63.2% of patients had precipitating factors on admission, such as defecation exertion （42.1%） ,and sudden change of gesture （ 10. 5% ）. Respiration rate and heart rate were obviously accelerated and right cham- bers were more obviously enlarged before death. Conclusions ： The prognosis of severe pulmonary hypertension patients is very poor. They often die from acute pulmonary edema and cardiogenic shock. Today there are no effective treatment. Severe pulmonary hypertension patients should avoid all kinds of precipitating factors,prevent from acute pulmonary edema or cardiogenic shock.
出处
《中国循环杂志》
CSCD
北大核心
2008年第1期40-42,共3页
Chinese Circulation Journal
关键词
肺动脉高难
急性肺水肿
心源性休克
Severe pulmonary hypertension
Acute pulmonary edema
Cardiogenic shock
作者简介
罗勤住院医师博士主要从事心血管内科专业Email：luoqinll@yahoo.com.cn
通讯作者：柳志红
