神经源性肺水肿(neurogenic pulmonary edema, NPE)是以急性、严重中枢神经系统损害所引发的急性呼吸窘迫为特征。NPE多发生于颅脑损伤(traumatic brain injury, TBI)、急性脑血管病、癫痫等严重颅内病变的患者,尤以脑卒中、蛛网膜下腔出血(subarachnoid hemorrhage, SAH)为多见,也可见于脑膜炎、吉兰‑巴雷综合征等患者。目前,缺乏具体的生物诊断指标和统一的诊断标准,导致不能快速诊断。文章旨在探讨围手术期NPE的相关病理生理学机制、临床表现、诊断与鉴别诊断、预后和治疗等,以期为NPE的诊断和治疗提供帮助。
Neurogenic pulmonary edema (NPE) is characterized by acute respiratory distress caused by acute and severe damage to the central nervous system. NPE is often prevalent in patients with severe intracranial lesions such as traumatic brain injury (TBI), acute cerebrovascular disease and epilepsy, especially in patients with stroke and subarachnoid hemorrhage (SAH), and also in patients with meningitis and Guillain-Barres syndrome. Currently, there is still lack of specific biological diagnostic indicators and unified diagnostic criteria, and many patients cannot be diagnosed quickly. This review aims to explore the pathophysiological mechanisms, clinical presentation, diagnosis and differential diagnosis, prognosis, and treatment of perioperative NPE, inorder to provide assistance for the diagnosis and treatment of NPE.
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