低分子肝素钠联合酚妥拉明治疗肺心病心衰30例临床剖析.docVIP

低分子肝素钠联合酚妥拉明治疗肺心病心衰30例临床剖析 　　[摘要] 目的 观察低分子肝素钠与酚妥拉明治疗肺源性心脏病(简称肺心病)心力衰竭的疗效。方法 将60例病人随机分为治疗组与对照组,对照组给予常规吸氧、抗炎、祛痰、平喘、纠正水电解质和酸碱平衡紊乱,适当强心、利尿及治疗原发病。治疗组在对照组治疗基础上加用低分子肝素钠与酚妥拉明治疗7d。结果 治疗组总有效率90%,对照组为66.7%,两组比较有显著性差异(P0.05)。结论 低分子肝素钠与酚妥拉明合用治疗肺心病心力衰竭有良好的疗效。 　　[关键词] 低分子肝素钠; 酚妥拉明; 肺心病; 心力衰竭; 疗效 　　[中图分类号] R541.5 [文献标识码] A [文章编号] 1673-9701(2010)07-106-02 　　 　　Low Molecular Heparin Plus Phentolamine for Pneumocardial Disease:An Analysis of 60 Cases 　　LI Junmin1 LV Wei1 QI Xueyuan2 　　1.Third Department of Internal Medicine,Huaibei Municipal Hospital of Chinese Medicine,Huaibei 235000,China;2.Department of Respiratory Medicine,the Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China 　　 　　[Abstract] ObjectiveTo observe the curative effect of low molecular heparin plus phentolamine in the treatment of heart failure in pneumocardial disease. MethodsSixty cases of pneumocardial disease were randomly divided into treatment group and control group. Both groups were given conventional treatment including oxygen uptake,anti-inflammatory agent,expectorant,antiasthmatic drug,correction of water- electrolyte and acid-base imbalance,adequate cardiac,diuretic and treatment of primary disease,and low molecular heparin plus phentolamine was added to the treatment group for 7 days. ResultsThe total efficiency of the treatment group was 90% and that of the control group was 66.7%,with a significant difference between the two groups(P0.05). ConclusionLow molecular heparin and phentolamine in the combined treatment of heart failure in pneumocardial disease have a good effect. 　　[Key words]Low molecular heparin; Phentolamine; Pneumocardial disease; Heart failure; Efficacy 　　 　　慢性肺源性心脏病(肺心病)急性加重期多由感染引发,导致严重的低氧血症和二氧化碳潴留,血液粘稠度增高和血容量增多,肺动脉高压加重,右心衰竭、肺心病加重。随着肺功能的损害病情逐渐加重,多数预后不良。目前治疗肺心病的药物很多,但疗效多不满意。本研究在常规治疗基础上,加用低分子肝素钠与酚妥拉明,观察其纠正心力衰竭的疗效,报道如下。 　　1 资料与方法 　　1.1 临床资料 　　选择2005年12月～2008年6月在我科住院的肺心病急性发作期患者60例,病史9～21年,均符合1980年全国第3次肺心病会议修订的慢性肺心病诊断标准[1],以美国纽约心脏病学会(NYNA)制定的心功能分级标准判断均为Ⅲ～Ⅳ级心功能。