肺水肿论文.doc

酚妥拉明及呋塞米对家兔实验性肺水肿治疗效果的对比 雷普润 郑志楠 李涵质 周欣 孟晶 指导老师：杨惠玲 潘运宝 (中山大学中山医学院 临床医学0年级班 摘要 肺水肿是指肺血管内液体渗入肺间质和肺泡，使肺血管外液量增多的病理状态，是一种较常见的临床急症，病死率较高。本文通过复制家兔肺水肿模型，探讨肺水肿的病理生理特点，并研究药物治疗方案。实验通过大剂量注射生理盐水后快速推注肾上腺素制成家兔实验性肺水肿模型来观察实验性肺水肿各种症状，以供早期诊断；同时分别利用呋噻米和酚妥拉明两种药物对其进行治疗，观察疗效；实验结果表明肾上腺素性肺水肿模型为临床症状典型；呋噻米和酚妥拉明对治疗急性肺水肿均有效果，但总体上呋噻咪抢救效果较酚妥拉明要好。 关键词 实验性肺水肿；肾上腺素；呋塞米；酚妥拉明 The treatment comparison of furosemid and phentolamine on pneumonedema Hanzhi LI Zhinan ZHENG Purun LEI Xin ZHOU Jing MENG Tutor: Huiling YANG Yunbao PAN [Abstract] pneumonedema refers to the pathological state that the liquid of pulmonary vessels is infiltrated into the pulmonary alveolus and the pulmonary interstitial substance, making the increase of the volume of the liquid outside the vessels, the Objective is To copy the model of pneumonedema in rabbit, prove the pathological characteristics of pneumonedema and to do the research on the treatment programs by drug. In the experiment, the rabbits were given adrenaline fast after being injected large doses of physiological saline so as to establish the model of pneumonedema. Then we explore the physiopathology and symptoms of pneumonedema to help us to do early diagnosis. After that, the rabbits were separately given furosemide and phentolamine as treatment, then we compared the efficacy of each approach. [Conclusion]:The results show that the rabbit given adrenaline for establishing the model of pneumonedema had obvious symptoms. Both furosemide and phentolamine had sound efficacy in treating pneumonedema, but totally the efficacy of furosemide is better than phentolamine. [Key words]:pneumonedema, adrenaline,furosemid,phentolamine 肺水肿是指肺脏内血管与组织之间液体交换功能紊乱所致的肺含水量增加，本病可严重影响呼吸功能，是临床上较常见的急性呼吸衰竭的病因，也是很多疾病重要的并发症之一。临床上常用药物及作用范围如下：1、吗啡对心原性肺水肿效果最好但禁用于休克呼吸抑制和慢性阻塞肺病合并肺水肿者利尿不宜用于血容量不足氧疗但禁用于心输出量不足者扩血管药应注意调整滴数和补充血容量保持动脉血压在正常范围强心药主要适用于快速心房纤颤或扑动诱发的肺水肿氨茶碱可有效地扩张支气管改善心肌收缩力增加肾血流量和钠排除但应注意注射速度预防对心脏的不利影响肾上腺糖皮质激素对肺水肿的治疗价值存在分歧 上述方法中呋噻米作为高效利尿药的代表治疗肺水肿的效果已得到公认；酚妥拉明为α受体阻滞剂，用于肺水肿治疗的报道并不多见；本文