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目的 观察特高海拔地区现场高压氧 (HBO)治疗对高原肺水肿 (HAPE)病人肺动脉压的影响 ;评价HBO对HAPE的疗效 ;探讨肺动脉高压 (PH)与HAPE的关系 ;强调现场就地治疗的重要性。方法 在 4636米特高海拔 (气压 5 7.41kPa,氧分压 1 2 .OkPa)现场治疗来自海拔 4636～ 5 1 30米 (气压5 7.41～ 5 3.2 8kPa/431 .6～ 40 0 .6mmHg,氧分压 1 2 .0～ 1 1 .6kPa/90 .0～ 87.0mmHg)的HAPE 32例。治疗前后对其临床症状、X光胸片、血氧饱和度 (SaO2 )、平均肺动脉压 (MPAP)进行自身对照。结果 治疗前后 32例HAPE临床症状、体征及MPAP等各项观测指标显著改善 ,P <0 .0 0 1。结论 特高海拔现场HBO救治HAPE效果肯定 ,它能使显著增高的肺动脉压降低 ,全部病例病情迅速改善 ,其中 1 1例 ( 34.3% )基本治愈。为下送进一步治疗创造了条件。HAPE患者均有PH ,而PH者未必一定发生HAPE ;PH是机体适应缺氧环境的正常代偿 ,PH失代偿的阈值确有必要探讨
Objective To observe the effect of hyperbaric oxygen (HBO) treatment on pulmonary artery pressure in patients with high altitude pulmonary edema (HAPE) at high altitudes, evaluate the effect of HBO on HAPE, investigate the relationship between pulmonary hypertension (PH) and HAPE, importance. Methods 4662 m high altitude (pressure 5 7.41kPa, partial pressure of oxygen 1 2. OkPa) field treatment from 4618 to 5130 meters above sea level (pressure 5 7.41 ~ 5 3.2 8kPa / 431.6 ~ 40 0 .6mmHg, oxygen Partial pressure 1 2 .0 ~ 1 1 .6 kPa / 90. 0 ~ 87.0mmHg) 32 cases of HAPE. Before and after treatment of its clinical symptoms, X-ray, oxygen saturation (SaO2), mean pulmonary artery pressure (MPAP) self-control. Results Before and after treatment, the clinical symptoms, signs, MPAP and other indexes of 32 HAPE patients were significantly improved (P <0.01). Conclusion HBO is effective in treating HAPE at the ultra-high altitude site. It can significantly lower the pulmonary arterial pressure and rapidly improve the condition of all cases, of which 11 (34.3%) patients are basically cured. To send further treatment to create the conditions. HAPE patients have PH, and PH may not necessarily occur HAPE; PH is the body to adapt to the normal environment of hypoxia, PH loss decompensation threshold is indeed necessary