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[病变性肺水肿的血流动力学数据]

[Hemodynamic data in lesional pulmonary edemas].

作者信息

Harari A, Lemaire F, Regnier B, Rapin M

出版信息

Ann Anesthesiol Fr. 1975;16 Spec No 2-3:127-32.

PMID:9856
Abstract

Pulmonary edema due to disorders in alveolo-capillary permeability (or lesional) are differentiated from hemodynamic pulmonary edema by the fact that they arise in spite of normal pulmonary capillary pressure (PCP). A hemodynamic study was carried out in 42 cases of lesional P.E. The PCP was normal whatever the date of the examination and the gravity of the P.E. Pulmonary arterial hypertension was only found in the presence of frank hypoxemia and disappeared with the correction of the latter. If there was no hemodynamic profile due to P.E. itself, its etiology sometimes induced a hyperkinetic or hypovolemic syndrome. Finally it was apparent that PCP was significantly higher- although normal- at the initial stage than after 6 hours of P.E.; that an elevation in PCP of only a few mm Hg by the perfusion of colloids aggravated the P.E., that despite the normal value for the PCP dehydration evidently improved hematosis. Thus this study confirms that numerous cases of P.E. can occur while the PCP remains normal. It also confirms the noxious nature of too abundant perfusions in these cases and the effectiveness of dehydration.

摘要

肺泡 - 毛细血管通透性紊乱(或损伤性)所致的肺水肿与血流动力学性肺水肿的区别在于,尽管肺毛细血管压(PCP)正常,但仍会出现肺水肿。对42例损伤性肺水肿患者进行了血流动力学研究。无论检查日期和肺水肿的严重程度如何,PCP均正常。仅在存在明显低氧血症时才发现肺动脉高压,纠正低氧血症后肺动脉高压消失。如果不存在由肺水肿本身引起的血流动力学特征,其病因有时会诱发高动力或低血容量综合征。最后很明显,尽管PCP正常,但在肺水肿初始阶段其值明显高于发病6小时后;通过输注胶体使PCP仅升高几毫米汞柱就会加重肺水肿,尽管PCP值正常,但脱水显然改善了血液状态。因此,本研究证实,在PCP保持正常的情况下,仍可发生大量肺水肿病例。它还证实了在这些情况下过度输液的有害性质以及脱水的有效性。

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