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目的探讨妊娠高血压综合征(妊高征)产后非心源性肺水肿的临床特点、识别及诊治方法。方法回顾分析3例妊高征产后并发非心源性肺水肿患者的临床资料。结果非心源性肺水肿的主要临床表现为呼吸困难、氧合下降、心动过速,X线胸片示斑片状阴影,而中心静脉压偏低或正常,超声心动图显示心脏的收缩和舒张功能正常。诊断时必须注意与心源性肺水肿相鉴别。治疗包括解痉,静脉滴注新一代羟乙基淀粉、白蛋白,应用利尿剂和呼吸支持等,均可获得良好效果。结论妊高征产后非心源性肺水肿比较少见,有效的治疗方法明显有别于心源性肺水肿,静脉滴注羟乙基淀粉和利尿剂具有良好的疗效。
Objective To investigate the clinical characteristics, identification and diagnosis and treatment of postpartum non-cardiogenic pulmonary edema in pregnancy-induced hypertension syndrome (PIH). Methods The clinical data of 3 patients with PIH complicated with non-cardiogenic pulmonary edema were retrospectively analyzed. Results The main clinical manifestations of non-cardiogenic pulmonary edema were dyspnea, decreased oxygenation, tachycardia, patchy shadows on X-ray and low or normal central venous pressure. Echocardiography showed systolic and Diastolic function is normal. Diagnosis must be differentiated from cardiogenic pulmonary edema. Treatment includes spasmolytic, intravenous infusion of a new generation of hydroxyethyl starch, albumin, application of diuretics and respiratory support, etc., can get good results. Conclusions The non-cardiogenic pulmonary edema after PIH is relatively rare. The effective treatment is obviously different from cardiogenic pulmonary edema. The intravenous hydroxyethyl starch and diuretic have good curative effect.