【摘要】 目的观察低浓度一氧化氮(NO)吸入联合3种药物及机械呼吸末正压通气治疗海水淹溺肺水肿的临床疗效。方法常规治疗组15例,无创性鼻／面罩双水平气道正压(BiPAP)通气,加东莨菪碱、纳络酮、甲基强的松龙治疗;综合治疗组12例,在常规治疗组基础上,一次性吸入0．002% NO气体30 min;比较两组病例肺部哕音、X片胸部阴影消失时间以及病程。结果综合治疗组肺部I罗音消失时间为(0．70±0．56)d,X片胸部阴影消失时间为(0．58±0．13)d,病程(2．50±1．30)d,常规治疗组分别为(2．15±1．66)d、(5．21±0．50)d、(5．80±3．00)d,差异有统计学意义(分别为P<0．05,P<0．01, P<0．01)。综合治疗组吸入NO前后SaO2值分别为79．0％±8．7％和90．0％±5．5％,两组比较差异有统计学意义(t=3．72,P<0．01)。结论短时间吸入低浓度NO联合3种药物及机械呼吸末正压通气治疗海水淹溺肺水肿,能迅速改善低氧血症和肺水肿,是一种有效、安全的方法。更多还原

【Abstract】 Objective To investigate the effectiveness of nitroic oxide (NO) of low concentration combined with three drugs and positive end-expiratory pressure mechanical ventilation in treating pulmonary edema caused by seawater drowning. Methods Fifteen patients were given nosal/facial mask Bi-level positive airway pressure ventilation plus scopolamine, naloxone and methylprednisolone (routine treatment group) . The other 12 patients were given NO (20×10-6) inhalation for 30 min except for routine treatment (synthetical treatment group). The pulmonary rales, the time of shadows on chest radiograph lasted, and the duration of disease of two groups were explored. Results In the synthetical treatment group, it took (0. 70±0. 56) d for pulmonary rales to disappear and (0. 58±0. 13) d for shadows on chest radiograph . And the disease had lasted for (2. 50±1. 30) d. While the above three guidelines in the routine treatment group were (2. 15±1. 66) d, (5.21±0.50) d and (5.80±3.00)d, respectively. The significant differences of the relevant data between the two groups were detected with a P value of <0.05, <0.01, <0. 01 accordingly. In addition,it was found that SaO2 values with NO inhalation treatment before and after were 79. 0%±8. 7% and 90. 0%±5. 5% , respectively. There were significant differences between them (t= 3. 72, P < 0. 01 ). Conclusions These findings suggest that hypoxemia and pulmonary edema could be quickly improved by inhalation of NO at low concentration for a short time and treated with three drugs and positive end-expiratory pressure mechanical ventilation after seawater drowning. The approach is safe and effective.更多还原