摘要
急性呼吸窘迫综合征（ARDS）是一种以快速进展的低氧血症伴非心源性肺水肿为特征的呼吸困难状态。尽管诊断和治疗方法在不断进步，但ARDS的病死率在全世界范围内仍高达40％-50％。在一些研究中发现，相当数量的ARDS患者合并急性肺源性心脏病（ACP），并且ACP与ARDS患者病死率独立相关，日益引起大家的关注。通过回顾近年来的相关研究，对ARDS合并ACP的流行病学、发病机制、诊断方法，尤其是作为诊断基础的超声心动图等进行深入总结，并阐明右心保护性通气策略及俯卧位通气对肺血管及右心的保护作用，为ARDS合并ACP的治疗提供新的思路。
Acute respiratory distress syndrome （ARDS） is a severe respiratory condition that is characterized by rapidly progressive hypoxemia with noncardiogenic pulmonary edema. Despite the improvement of therapeutic methods, the mortality of ARDS is in the range of 40%-50% all over the world. Some studies have shown that a significant number of patients with ARDS had acute cor pulmonale （ACP）, and ACP is independently associated with the mortality of patients with ARDS, which has attracted wide attention in recent years. This paper reviewed recent related studies, summarized the prevalence, pathogenesis and diagnostic approaches of ACP in ARDS, especially echocardiography which was considered as a cornerstone for ACP diagnosis, and elucidated the beneficial effects of right ventricular protective ventilatory strategy and prone-positioning on the pulmonary vasculature and right heart, in order to provide a novel idea for the therapy of ACP in ARDS.
作者
张峰
曹权
左祥荣
Zhang Feng Cao Quan Zuo Xiangrong(Department of Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China)
出处
《中华危重病急救医学》
CAS
CSCD
北大核心
2017年第3期272-275,共4页
Chinese Critical Care Medicine
基金
国家自然科学基金（81200159）
江苏省“六大人才高峰”项目（2012-WS-028）
江苏高校优势学科建设工程资助项目（JX10231801）
关键词
急性呼吸窘迫综合征
急性肺源性心脏病
右心功能不全
超声心动图
俯卧位通气
Acute respiratory distress syndrome
Acute cor pulmonale
Right ventricular dysfunction
Echocardiography
Prone position ventilation
作者简介
通讯作者：左祥荣，Email：13913979197@139．com
