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目的观察低分子肝素钙与酚妥拉明联合治疗肺心病心力衰竭的疗效及安全性。方法将170例肺心病心力衰竭患者随机分为观察组和对照组各85例,两组患者均给予卧床休息、吸氧、平喘、祛痰、抗感染、强心、利尿、扩张血管、纠正电解质及酸碱平衡紊乱等常规治疗,观察组在此基础上联合应用低分子肝素钙皮下注射和静脉滴注酚妥拉明,疗程均为14 d。结果观察组显效率和总有效率明显优于对照组(P<0.001);CO、SV、LYEF等心功能指数明显比对照组升高(P均<0.05);PaO2增高幅度、PaCO2降低幅度明显优于对照组(P均<0.001);全血黏度高切与低切、红细胞比容及纤维蛋白原等血液流变学指标比对照组明显改善(P均<0.001);两组不良反应差异无统计学意义(P>0.05)。结论低分子肝素钙与酚妥拉明联合治疗肺心病心力衰竭,具有起效迅速、使用安全、疗效满意等优势,具有较好临床应用价值。
Objective To observe the efficacy and safety of low molecular weight heparin combined with phentolamine in the treatment of heart failure due to cor pulmonale. Methods A total of 170 patients with heart failure of cor pulmonale were randomly divided into observation group (n = 85) and control group (n = 85). The patients in both groups were given bed rest, oxygen inhalation, asthma, expectorant, antiinflammatory, cardiac, diuretic, Electrolyte and acid-base balance disorders and other conventional treatment, the observation group on the basis of combination of low molecular weight heparin calcium injection and intravenous infusion of phentolamine, treatment were 14 d. Results The markedly effective rate and total effective rate in the observation group were significantly higher than those in the control group (P <0.001). The cardiac function indexes such as CO, SV and LYEF were significantly higher than those in the control group (all P <0.05); PaO2 increased and PaCO2 decreased significantly (P <0.001). The indexes of hemorheology such as high and low shear rate of whole blood viscosity, hematocrit and fibrinogen were significantly improved (P <0.001). The difference of adverse reaction between the two groups No statistical significance (P> 0.05). Conclusion Low molecular weight heparin calcium and phentolamine combined treatment of heart failure of pulmonary heart disease, with rapid onset, safe use, satisfactory efficacy and other advantages, has good clinical value.