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目的:探讨西宁地区慢性肺源性心脏病(肺心病)急性加重期的临床特点及防治措施。方法:对2007年1月—2009年12月住院病例临床表现、实验室检查及治疗措施进行分析比较。结果:西宁地区慢性肺心病急性加重期病因以慢性阻塞性肺疾病占92.63%,死因主要为心衰、呼衰、肺性脑病及由此而导致的多脏器功能衰竭;发热以低中热为主,血常规中性粒细胞增高占78.57%,咳痰以黄黏液为主占57.93%,胸片斑片状影占93.65%;合并呼吸衰竭89.68%,合并继发性红细胞增多症64.29%,电解质紊乱(低钾、低钠、低氯血症)为80.26%;合并肝功能损害60.3%、肾功能不全23.81%等。结论:高海拔地区慢性肺心病是机体长期缺氧的慢性病理过程,常合并多脏器功能改变,常因感染而急性加重,故急性加重期应控制性持续氧疗,保持呼吸道通畅,积极控制感染、改善心肺功能,纠正电解质紊乱是关键。
Objective: To investigate the clinical characteristics and prevention and treatment of acute cor pulmonale of chronic cor pulmonale (pulmonary heart disease) in Xining area. Methods: The clinical manifestations, laboratory tests and treatment measures of inpatients from January 2007 to December 2009 were analyzed and compared. Results: The causes of acute exacerbation of chronic pulmonary heart disease in Xining area were 92.63% with chronic obstructive pulmonary disease. The main causes of death were heart failure, respiratory failure, pulmonary encephalopathy and multiple organ failure. Mainly blood routine neutrophils accounted for 78.57%, sputum mainly yellow mucus accounted for 57.93%, chest film patchy accounted for 93.65%; combined respiratory failure 89.68%, with secondary polycythemia 64.29% , Electrolyte disturbance (hypokalemia, hyponatremia, hypochlorosis) was 80.26%; combined dysfunction of liver 60.3%, renal insufficiency 23.81% and so on. Conclusion: Chronic pulmonary heart disease (COPD) is a chronic pathological process of long-term hypoxia in the high altitude area. It is often associated with multiple organ dysfunction. It is often aggravated by infection. Therefore, it should be controlled by continuous continuous oxygen therapy during acute exacerbation, to keep the airway open and to actively control Infection, improve heart and lung function, correct electrolyte imbalance is the key.