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[上气道梗阻后肺水肿]

[Pulmonary edema after upper airway obstruction].

作者信息

Larsen K M, Nielsen L S

机构信息

Anaestesi- og intensiv afdeling, Herning Centralsygehus.

出版信息

Ugeskr Laeger. 1995 Jun 12;157(24):3464-7.

PMID:7792973
Abstract

Post obstructive pulmonary edema (POPE) is a rare, but potentially dangerous condition. We present two patients with post-anaesthetic POPE. The literature is reviewed and aetiology, risk factors, pathogenesis, symptoms, prophylaxis and management are discussed. The condition is often associated with upper airway obstruction related to anaesthesia, but is also related to other causes of upper airway obstruction. Development of pulmonary edema can be delayed for up to 90 minutes. The treatment consists of oxygen therapy by nasal catheter or by mask with continuous positive airway pressure. In severe cases, intubation and mechanical ventilation by respirator with positive end-expiratory pressure is necessary. Further therapy is controversial and without significant effect. With sufficient therapy, almost all patients regain their habitual condition within 24-48 hours and present a normal chest X-ray.

摘要

梗阻后肺水肿(POPE)是一种罕见但可能危险的病症。我们报告了两名麻醉后发生POPE的患者。本文回顾了相关文献,并讨论了病因、危险因素、发病机制、症状、预防措施及治疗方法。该病症常与麻醉相关的上呼吸道梗阻有关,但也与其他上呼吸道梗阻原因有关。肺水肿的发展可能会延迟长达90分钟。治疗方法包括通过鼻导管或面罩进行氧气治疗,并持续气道正压通气。在严重情况下,需要进行气管插管并使用带有呼气末正压的呼吸机进行机械通气。进一步的治疗存在争议且效果不显著。经过充分治疗,几乎所有患者在24至48小时内恢复至 habitual condition(此处原文有误,应为habitual state),胸部X线检查结果正常。

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