Saito H, Dambara T, Mimoto T, Yamaguchi K, Oka M, Aiba M, Nukiwa T, Kira S
Nihon Kyobu Shikkan Gakkai Zasshi. 1989 Jul;27(7):818-24.
A 55-year-old male was admitted to our hospital for subarachnoid hemorrhage complicated with liver cirrhosis on Jan. 8th, 1988. Chest X-ray film on admission showed bilateral infiltrative shadows, which disappeared on Jan. 10th. However the same type of shadow reappeared on Jan. 12th. Although he received surgical treatment for subarachnoid hemorrhage, pulmonary deterioration occurred five times until the 21st post-operative day. These changes responded to diuretics and control of water balance. Cardiac function evaluated by ultrasonocardiography and right cardiac catheterization, and the composition and amount of plasma protein concentration were within normal limits. Although the mechanism of repeated appearance of the shadow was not clear, the edema was thought to be neurogenic. As this case showed, the control of water balance and the use of diuretics are essential for treatment of this neurogenic pulmonary edema.
一名55岁男性于1988年1月8日因蛛网膜下腔出血合并肝硬化入住我院。入院时胸部X光片显示双侧浸润性阴影，于1月10日消失。然而，1月12日同样类型的阴影再次出现。尽管他接受了蛛网膜下腔出血的手术治疗，但直到术后第21天肺部恶化仍发生了5次。这些变化对利尿剂和水平衡的控制有反应。通过超声心动图和右心导管检查评估的心脏功能以及血浆蛋白浓度的组成和量均在正常范围内。尽管阴影反复出现的机制尚不清楚，但水肿被认为是神经源性的。如该病例所示，控制水平衡和使用利尿剂对于治疗这种神经源性肺水肿至关重要。
