酚妥拉明联合肝素治疗肺心病中、重度心力衰竭的分析.docVIP

酚妥拉明联合肝素治疗肺心病中、重度心力衰竭的分析 杨安仲，苏尊伟，张宁 作者单位：641000，四川省内江市第二人民医院急诊科 ［摘要］ 目的　探讨酚妥拉明联合肝素治疗肺心病中、重度心力衰竭的疗效。方法　将72例病人随机分为治疗组和对照组，各36例，两组均给予抗生素、解痉平喘、止咳化痰、强心、利尿、吸氧等综合治疗，治疗组在对照组的基础上加用酚妥拉明15-20mg，肝素10000U-40000U加入5%葡萄糖液250ml缓慢静滴，每日1 次，7d为一疗程。结果 治疗组血细胞比容由治疗前0.57±0.07降为0.42±0.04，明显优于对照组(P0.01)。治疗组纤维蛋白原由治疗前0.58±0.10降为0.43±0.06，亦明显优于对照组(P0.01)。治疗组心率由治疗前121±11降为83±8.2，与对照组相比差异显著(P0.01)。治疗组尿量由治疗前694±37增至1561±61 。结论 酚妥拉明联合肝素治疗肺心病中、重度心力衰竭是一安全有效的方法，值得广泛应用。 ［关键词］ 酚妥拉明；肝素；肺心病；心力衰竭。 [Abstract] Objective To investigate the effect of phentolamine combined with heparin in treating pulmonary heart disease and severe heart failure. Methods 72 patients were randomly divided into treatment group and control group, all 36 cases, two groups were given antibiotics, antispasmodic asthma, relieving cough and phlegm, strong heart, diuretic, oxygen uptake and other comprehensive treatment. In addition,the patients in the treatment group were given phentolamine 15-20mg, heparin 1-4 myria by adding 5% glucose solution u slow intravenous infusion of 250ml a day 1, 7d for a course of treatment. Results The pre-treatment, hematocrit from the treatment group reduced from 0.57 ± 0.07 to 0.42 ± 0.04, significantly better than that from the control group (P lt;0.01). The pre-treatment fibrinogen reduced from 0.58 ± 0.10 in the treatment group to 0.43 ± 0.06, markedly higher than that in the control group (P lt;0.01). Heart rate in the treatment group reduced from 121 ± 11 before-treating to 83 ± 8.2, compared with control group,there was a significant difference (P lt;0.01). Urine from the treatment group increased from 694±37 before treating to 1561±61. Conclusion phentolamine combined with heparin is a safe and effect method It is in treating pulmonary heart disease, severe heart failure worthy of wider application. [Key words] phentolamine; heparin; pulmonary heart disease; heart failure. 肺心病心力衰竭是内科的危重病，特别是肺心病中、重度心力衰竭病人。自2005年开始，我科用酚妥拉明联合肝素治疗肺心病心力衰竭36例，取得满意疗效。现将资料整理分析如下。 1、资料与方法 1.1 一般资料 所有病例均符合肺心病的诊断标准