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目的:通过分析较大样本高原肺水肿的临床表型特点规律,为早期诊断及防治提供依据。方法:采用现况调查研究,对2009年4月—2011年6月连续入院确诊为高原肺水肿患者的基本特征、发病时间规律、累及部位及严重程度等进行临床流行病学研究。结果:1共入选300例汉族高原肺水肿患者,其中男232例,女68例;平均年龄(38.57±13.85)岁;2发病时间从平原到达高海拔地区拉萨(海拔3 658m)后计算,12小时内发病的占43.67%,(12~24)小时内发病的占26.33%,(24~48)小时内发病的占17.00%,(48~72)小时内发病的占9.00%,(72~96)小时内发病的占2.67%,96小时后发病的仅占1.33%;3高原肺水肿患者经皮指式血氧饱和度平均水平为65.14%±12.75%,95%可信区间为62.14%~64.89%。Sa O265%以下者(含65%)占50.34%,Sa O275%以下者占78.67%,Sa O285%以下者占94.00%;4肺部累及部位情况,累及双肺者占83.00%,单纯右肺者占15.33%,单纯左肺者仅占1.67%。结论:高原肺水肿患者以青壮年为主,男性多见,发病时间早,并以进入高原前三天为高峰,临床缺氧程度严重,因此,早期发现、早期诊断和早期治疗仍然为高原肺水肿防治的关键。
Objective: To provide a basis for early diagnosis and prevention by analyzing the characteristics of clinical phenotypes of large samples of high altitude pulmonary edema. Methods: The current epidemiological study was conducted on the basic characteristics, the time of onset, the site of involvement and the severity of the patients admitted to the hospital from April 2009 to June 2011 for continuous diagnosis of high altitude pulmonary edema. A total of 300 cases of pulmonary edema in the Han plateau were enrolled, including 232 males and 68 females, with an average age of (38.57 ± 13.85) years. 2 The time of onset was from Lhasa (3 658 m above sea level) (43.67%) in the first hour, 26.33% in the (12-24) hours, 17.00% in the 24-48 hours, 9.00% in the 48-72 hours, 96) accounted for 2.67% in the first hour and only 1.33% in the first 96 hours. 3 The average level of oxygen saturation of percutaneous finger in patients with high altitude pulmonary edema was 65.14% ± 12.75% and the 95% confidence interval was 62.14% ~ 64.89%. Sa O265% or less accounted for 50.34%, Sa O275% or less accounted for 78.67%, Sa O285% or less accounted for 94.00%; 4 lung involvement sites, involving the lungs accounted for 83.00% of the simple right lung Who accounted for 15.33%, only left lung accounted for only 1.67%. Conclusion: High altitude pulmonary edema in patients with young and middle-aged, more common in men, the onset time as early as three days before entering the plateau and the peak of the degree of clinical hypoxia, therefore, early detection, early diagnosis and early treatment is still high altitude lung The key to prevention and treatment of edema.