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1 临床资料 本组54例均符合1977年全国第二次肺心病专业会议制定的标准。本组难治性心衰指:①病情本身重、明显紫绀、哮喘较重、神志模糊;②经一般休息及正规治疗效果差者;③伴有较重的并发症如高血压、冠心病、心律失常、呼吸衰竭者。其男43例,女11例。咳喘病史为10～35年,年龄为29～83岁。原发病为慢性支气管炎者38例,支气管哮喘者5例,支气管扩张者6例,肺结核者5例。有肺淤血或/和肺水肿征—呼吸困难、紫绀、肺部湿罗音者47例。有体循环充血征—少尿、肝肿大、顽固性水肿者38例。并发心律失常者8例,高血压者7例,冠心病者5例,肺性脑病者6例。 2 治疗方法 在综合治疗抗感染、吸氧、适时强心、利尿、维持水电解质平衡等措施及查出凝血时间后,加用肝素100mg溶于10％葡萄糖250ml中每分钟20～25滴
1 Clinical data The group of 54 cases are in line with the 1977 National Conference of the professional pulmonary heart disease developed standards. This group of refractory heart failure refers to: ① the condition itself, significantly cyanotic, asthmatic heavier, ambiguous; ② after the general rest and the effect of poor treatment were poor; ③ accompanied by severe complications such as hypertension, coronary heart disease, Arrhythmia, respiratory failure. There were 43 males and 11 females. Cough history is 10 to 35 years, aged 29 to 83 years old. The primary disease was chronic bronchitis in 38 cases, 5 cases of bronchial asthma, bronchiectasis in 6 cases, 5 cases of tuberculosis. Pulmonary congestion and / or pulmonary edema sign - Breathing difficulties, cyanosis, pulmonary wet rales in 47 cases. Symptoms of systemic congestion - oliguria, hepatomegaly, refractory edema in 38 cases. 8 cases of arrhythmia, hypertension in 7 cases, coronary heart disease in 5 cases, 6 cases of pulmonary encephalopathy. 2 treatment in the comprehensive treatment of anti-infective, oxygen, timely cardiac, diuretic, maintain water and electrolyte balance and other measures and detect clotting time, add heparin 100mg dissolved in 10% glucose 250ml per minute 20 to 25 drops