高原缺氧相关肺动脉高压

高原缺氧相关肺动脉高压内容摘要：

肺动脉高压及右心增大征象 – 经临床及心电图等检查排除心肌梗死、心力衰竭和肺炎等其他心肺疾患 – 经卧床休息、吸氧等治疗或下送 , 症状迅速好转 , X 线征象可于短期内消失。 高原肺水肿影像学改变 高原肺水肿影像学改变 Radiograph of a 37yearold male mountaineer with HAPE that shows a patchy to confluent distribution of edema, predominantly on the right side CT scan of27yearold mountaineer with recurrent HAPE showing patchy distribution of edema 高原肺水肿影像学改变 高原肺水肿治疗 • 卧床休息 – 一旦发现病人 , 严禁继续登高 , 绝对卧床休息 • 下送原则 • 氧疗 – 是非常重要的治疗方法 , 效果显著 , 应早期充分给氧 • 一般采用持续低流量吸氧 ( 4 ~ 8L/ min) • 对缺氧严重者可给予高流量持续吸氧 ( 10L/ min) • 有条件时可应用进行高压氧治疗 , 效果更好 • 氧疗加 NIPPV治疗 • 降低肺动脉压的药物 – 硝苯地平 – 氨茶碱 – 酚妥拉明 – 山莨菪碱 • 利尿剂 • 其他 – 激素 – Β2受体激动剂吸入 • doubleblind study • 14 healthy volunteers • 100 mg sildenafil or placebo was administered • exposure to hypobaric hypoxia at rest and after exercise to 5,000 m of simulated altitude • Arterial oxygen saturation (SaO2), heart rate (HR), tidal volume (VT), respiratory rate (RR), left ventricular ejection fraction (EF), and pulmonary arterial pressure (PAP) were measured first at rest in normoxia, at rest and immediately after exercise during hypoxia, and after exercise in normoxia • Th。