放血稀释疗法加阿魏酸钠治疗肺心病的疗效观察

作者	单位
杨如兰	四川省达县地区医院
王廷杰	四川省达县地区医院
刘达康	四川省达县地区医院
李方之	四川省达县地区卫生学校

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中文摘要:

本文介绍30例肺心病患者采用放血稀释疗法继以活血化瘀中药阿魏酸钠治疗,可使血红蛋白、红血球压积与全血粘度分别下降9.03%、11.05%及15.15%(P<0.05～0.005),氧分压上升,与同期单纯西药组38例,阿魏酸钠组48例、肝素治疗组30例进行对比,对照组治疗后各项指标均无显著差异(P>0.05),放血后心肺功能改善均超过Ⅰ级以上,有20例合并慢性呼吸衰竭者迅速转危为安。我们认为放血稀释疗法可以迅速减轻心脏容量负荷和阻力负荷,继以阿魏酸钠治疗可进一步巩固疗效。

英文摘要:

30 cases of cor pulmonale（CP）were treated by means of hemospasia therapy and sodium ferulate intravenous dripping in our hospital from Oct.1983 to Nov.1984.They were compared with 38 cases of comprehensive therapy,48 cases of sodium ferulate only,and 30 cases of heparin therapy.Before treatment there was no significant difference in severity of illness,age,indexes of hemorheology and partial pressure of arterial oxygen（PaO₂）among the four groups（P>0.05）.After treatment,there was no marked change among the three control groups（P>0.05）.But in the group of hemospasia therapy,the results showed that mean hemoglobin（Hb）lowered by 9.03%,hematocrit（Ht）by 11.05%,whole blood viscosity by 15.15%（P<0.05～0.005）,the serum viscosity and PaO₂ did not change significantly（P>0.05）.After hemospasia,systolic pressure reduced（P<0.02）,but diastolic pressure,heart rate,cardiac output and cardiac index had no significant change（P>0.05）. The amount of hemospasia was 50 to 350 ml/time,which may be repeated in one week or two.Altogeth- er,the sum was 250 to 1220 ml.After hemospasia,500 ml of Dextran-40 or Dextran was infused immediately, then sodium ferulate was dripped intravenously every day.After treatment,the patients’symptoms alleviated, they felt relaxed,the palpitation and chest oppression lightened,the cardio-pulmonary function improved.No case of death was reported.In 20 cases of CP with respiratory failure,their Ht and blood viscosity decreased rapidly,time had been won for further treatment.

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