CAJ | 학술논문

1例68岁原发性肝癌男性患者因行肝动脉导管化疗输注碘普罗胺30 ml.输注完毕后约20 min,患者突发呼吸困难,血压130/76 mm Hg(1mm Hg =0.133 kPa),心率136次/min,脉搏血氧饱和度0.80.给予地塞米松10 mg静脉注射.动脉血气分析:pH 7.31,二氧化碳分压34 mm Hg,氧分压69 mm Hg.胸部X线检查示两肺多发斑片状阴影.考虑为碘普罗胺所致非心源性肺水肿.行无创呼吸机辅助通气,并静脉注射呋塞米20 mg.约12 h后患者呼吸困难改善,氧合指数为110.治疗后36 h,改为面罩吸氧,氧合指数上升至132.2d后采用鼻导管吸氧,氧合指数达175；5d后氧合指数升至260.约2周后,患者呼吸困难症状消失,动脉血气分析各项指标均正常.
1례68세원발성간암남성환자인행간동맥도관화료수주전보라알30 ml.수주완필후약20 min,환자돌발호흡곤난,혈압130/76 mm Hg(1mm Hg =0.133 kPa),심솔136차/min,맥박혈양포화도0.80.급여지새미송10 mg정맥주사.동맥혈기분석:pH 7.31,이양화탄분압34 mm Hg,양분압69 mm Hg.흉부X선검사시량폐다발반편상음영.고필위전보라알소치비심원성폐수종.행무창호흡궤보조통기,병정맥주사부새미20 mg.약12 h후환자호흡곤난개선,양합지수위110.치료후36 h,개위면조흡양,양합지수상승지132.2d후채용비도관흡양,양합지수체175；5d후양합지수승지260.약2주후,환자호흡곤난증상소실,동맥혈기분석각항지표균정상.
A 68-year-old man with primary hepatic carcinoma received an infusion of iopromide 30 ml for transhepatic arterial chemotherapy.About 20 minutes after completion of the infusion,the patient suddenly developed dyspnea.Physical examination showed a blood pressure of 130/76 mm Hg,a heart rate of 130 beats/min,and a saturation of pulse oximetry of 0.80.Intravenous (Ⅳ) dexamethasone 10 mg was given.Arterial blood gas analysis revealed the following levels:pH 7.31,partial pressure of carbon dioxide 34 mm Hg,and partial pressure of oxygen 69 mm Hg.Chest radiograph examination indicated multiple patchy shadows diffusing in bilateral lungs.The diagnosis of iopromide-induced noncardiogenic pulmonary edema was considered.The patient received non-invasive assisted ventilation and Ⅳ furosemide 20 mg were administered.About 12 hours later,his dyspnea was improved and oxygenation index (OI) value was 110.Thirty-six hours after therapy,he was treated with oxygen masks and the value of OI was 132.Two days later,he received oxygen inhalation through nasal tube and the value of OI was 175 and,five days later,the value of OI reached 260.About two weeks later,his dyspnea disappeared and arterial blood gas analysis revealed all the measurements were normal.