重型颅脑损伤并发神经源性肺水肿15例诊治分析

Clinical analysis of 15 patients with severe craniocerebral injury complicated with neurogenic pulmonary edema

摘要: 目的：探讨重型颅脑损伤患者并发神经源性肺水肿的诊断及治疗要点。方法：对15例颅脑损伤并发神经源性肺水肿患者给予有效降低颅内压，保持呼吸道通畅，如吸氧不能纠正缺氧时使用呼吸机机械通气，应用血管扩张剂，减轻肺循环负荷，控制肺部感染等治疗。结果：存活7例，死亡8例。结论：重型颅脑损伤并发神经源性肺水肿是严重危害患者生命的脑外伤并发症。早期发现、及时治疗、积极抢救是提高救治成功率、降低病死率的关键。

Abstract: Objective:To explore the key points of diagnosis and treatment of severe craniocerebral injury complicated with neurogenic pulmonary edema(NPE).Methods:Fifteen patients with severe craniocerebral injury complicated with NPE were treated with reducing intracranial pressure and keeping airway open.The vasodilator agents,relieving pulmonary circulating load and controlling pulmonary infection were applied when hypoxic condition was not corrected after inhaling oxygen.Results:Seven patients survived and 8 patients died.Conclusions:The severe craniocerebral injury complicated with NPE is serious complications of severe craniocerebral injury.Early diagnosis and treatment are the key of improving the success rate of treatment and lowering the death rate.