大叶性肺炎是一个常见的疾病,但合并虚脱者不多见,国内亦无专文报道。近来我科发现该类病例不少,为探讨其发病机制和处理原则,经过座谈后,重点记录如下,供同道工作中参考。发病机制 1831年Laennec氏首先报告大叶性肺炎合并虚脱,由于心力衰竭所致。1907年Janeway氏认为是由于周围血液潴留于毛细血管内所引起。1911年Lambert氏认为心肌萎缩和血管虚脱都有关系。前者多见于酒癖、慢性贤炎及动脉硬化等患者;后者多见于严重中毒病例。1914年Willson氏从尸体解剖证明大叶性肺炎和枝气管肺炎患者的心脏有急性弥漫性心肌炎,细胞浸润、心肌肌纹消失或广泛性出血。1945年Warren氏认为虚脱是由于血容量少与血床变大的差异。俄国包特金氏认为是由于血管运动机能不全所致 Lobar pneumonia is a common disease, but few people with combined collapse, there is no domestic article reported. Recently, we found that many cases of such cases, in order to explore the pathogenesis and treatment principles, after the discussion, the key record is as follows for reference for fellow work. Pathogenesis In 1831, Laennec first reported lobar pneumonia with collapse due to heart failure. Janeway’s 1907 thought was due to the surrounding blood retention in the capillaries. 1911 Lambert think that myocardial atrophy and vascular collapse are related. The former more common in alcoholism, chronic inflammation and atherosclerosis and other patients; the latter more common in severe poisoning cases. In 1914, Willson’s autopsy from the corpse proved that patients with lobar pneumonia and bronchial pneumonia had acute diffuse myocarditis, cell infiltration, disappearance of myocardial myenterium, or extensive bleeding in the heart. Warren’s view of collapse in 1945 was due to a difference in hypovolemia and blood bed enlargement. Baggin in Russia is due to inadequate vascular motor function