临床中非心源性肺水肿出现时,危险系数高,愿各位版主多多设立相关话题。
非心源性肺水肿 的检查
高原性肺水肿:病理检查发现两肺湿润,充满浆液血性水肿液,细支气管和肺泡水肿,且有透明膜附着于肺泡壁;在毛细血管和中小型肺动脉内有小血栓形成。
(一)感染性肺水肿:起病24-48小时后,病人的呼吸困难加剧,咳血痰,高热,体检和胸部X线呈典型肺水肿。
(二)尿毒症性肺水肿:病人有进行性气促,体检有典型性肺水肿体征。典型的肺部X线表现为两侧肺门旁对称性的蝶状阴影。纤维蛋白性胸膜炎常和肺水肿并存。
(三)职业中毒性肺水肿:呼吸道接触刺激性毒物后即发生刺激性反应,引起呛咳、气促、胸闷、乏力、头晕、头痛等症状;体征甚少。在脱离毒物接触后1-2小时,症状自行缓解,以至消失。大部分病人在数小时至2天后出现肺水肿症状、体征和X线表现。
(四)肺复张性肺水肿:临床表现轻重不一,重症有严重呼吸困难、休克,可致死亡。
(五)高原性肺水肿:症状常发生在快速登山6-36小时后,有倦怠、不适、心悸、气促及持续的刺激性干咳,随后出现端坐呼吸、紫绀、咳大量粉红色泡沫痰或咯血。体征和X线检查有典型的肺水肿表现。不及时救治,可导致死亡。
Non-cardiogenic pulmonary edema check
High altitude pulmonary edema: pathological examination revealed two lungs moist, hemorrhagic edema filled with serous fluid, Bronchioles and alveolar edema, and a transparent membrane attached to the alveolar walls; there are small and medium pulmonary thrombosis in capillaries.(A) infectious pulmonary edema: 24-48 hours after onset, the patient's dyspnea, cough, bloody sputum, fever, medical examination and a chest x-ray is a typical Lung edema.(B) of uremic pulmonary edema: patients with progressive shortness of breath, medical examination there are signs of severe pulmonary edema. Typical chest x ray findings of lung symmetry of butterfly-shaped shadow next to the door. Fibrin pleurisy and pulmonary edema often exist side by side.(C) occupational toxic pulmonary edema: respiratory exposure to irritant reaction after irritant poison, causing qiangke, shortness of breath, chest tightness, fatigue, dizziness, headache and other symptoms; signs are rare. Out of 1-2 hours after toxicant exposure, symptoms disappear spontaneously, and even disappear. Most patients develop pulmonary edema symptoms in a few hours to 2 days, signs, and x-ray.(D) pulmonary reexpansion pulmonary edema: clinical manifestations of varying severity, severe with severe breathing difficulties and shock, can lead to death.(E) high altitude pulmonary edema: symptoms often occur in fast-climbing 6-36 hours later, fatigue, discomfort, palpitations, shortness of breath and persistent irritating dry cough, then sits in the breathing, cyanosis, coughing up phlegm or hemoptysis large pink bubble. Signs of pulmonary edema and x-ray examination are typical manifestations. Without timely treatment, can be fatal. |