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既往无先天性心脏病的孕妇发生肺水肿可由早产使用β-模拟剂、重度先兆子痫高血压、羊水栓塞或分娩时败血症所引起。本文附一例报告。孕妇35岁,孕38周。因半昏迷、发绀、严重气短及吸气性喘鸣入院。甲状腺轻度肿大已有两年,但功能正常。孕期患者发现甲状腺逐渐增大并伴有吞咽困难及卧位呼吸困难,其他情况正常。既往无先兆子痫、高血压及充血性心力衰竭等病史。入院后立即用直径7.0mm的导管行气管插管,过程顺利,吸出大量白色泡沫状分泌物。胸部X光证实严重肺水肿的临床诊断。血压80/60mmHg。插管后即刻及在用1.0的FIO_2通气后采血行动脉血气分析,显示PO2为54mmHg,pH为7.30。
Previous pulmonary edema in pregnant women without congenital heart disease can be caused by preterm birth with β-mimics, severe pre-eclampsia, amniotic fluid embolism, or sepsis at childbirth. This article attached a case report. Pregnant women 35 years old, 38 weeks pregnant. Due to semi-coma, cyanosis, severe shortness of breath and aspiration wheezing. Thyroid mild swelling for two years, but normal function. Pregnant patients found that thyroid gradually increased and accompanied by dysphagia and breathing difficulties, other conditions are normal. Past history without preeclampsia, hypertension and congestive heart failure. Immediately after admission with a diameter of 7.0mm catheter tracheotomy tube, the process goes well, sucked out a large number of white foam secretions. Chest X-ray confirmed the clinical diagnosis of severe pulmonary edema. Blood pressure 80 / 60mmHg. Immediate arterial blood gas analysis immediately after intubation and after using 1.0 FIO_2 ventilation showed that PO2 was 54 mmHg and pH was 7.30.