慢性肺源性心脏病伴呼吸衰竭104例临床观察  

Clinical Observation of 104 Cases of Chronic Pulmonary Cardiopathy with Respiratory Failure

作　　者：张北暾 唐晓燕[2] 谢敏[2] 刘守智[2] 陈文彬[2] 

机构地区：[1]乐至县中医院呼吸科,四川乐至641500 [2]四川大学华西医院呼吸科,四川成都610041

出　　处：《华西医学》2005年第2期253-255,共3页West China Medical Journal

摘　　要：目的:探讨肺心病伴呼吸衰竭的治疗方法、治疗难点和治疗失误。方法:对华西医院呼吸科1995年09月～1997年09月收治的104例确诊肺心病伴呼吸衰竭患者的治疗措施及预后转归和死亡原因进行回顾性分析。结果:104例患者男61例,女43例,平均年龄为(62.8±18.5)岁,其中45—70岁的占67.9%。好转55例,占52.9%,45例死亡,死亡率43.3%。伴发糖尿病及肺部真菌感染与预后不良显著相关。伴肺性脑病、呼吸机相关肺炎是肺心病死亡的高危因素。结论:肺心病伴肺部严重感染、其他系统性疾病、肺性脑病、DIC、上消化道出血、感染中毒性休克、水电解质失衡及酸碱平衡紊乱、心律失常以及呼吸机相关肺炎的重症患者预后不良,死亡率高。机械通气能提高抢救成功率,降低病死率。Objective:To study the methods,nodus and lapsus of the treatment of chronic pulmonary heart disease with respiratory failure.Methods:The data of 104 patients of chronic pulmonary heart disease admitted in the department of respiratory diseases in West China Hospital from Sept 1995 to Sept 1997,were reviewed to analyse the therapy method,prognosis and the cause of death.Results:The average age of the 104 patients(61 male and 43 female)was 62.8±18.5,among which the patients from 45～70 years old accounts for 67.9%.55 patients(52.9%)were improved ,while 45 patients(43.3%)died.The concomitant diabetes,pumonary fungal infection were significantly correlated with the bad prognosis.And the pulmonary encephalopathy,ventilator associated pneumonia were high risk factors for the death of pulmonary heart disease.Conclusion:The patients of pulmonary heart disease with severe pulmonary infections,other systematic diseases,pulmonary encepalopathy,DIC,upper gastrointestinal hemorrhage,septic shock,water-electrolyte and acid-base disturbance,arrythmia and ventilator associated pneumonia have a worse prognosis more likely.The mechanic Ventilation can improve the progrosis and reduce the mortality.

关 键 词：肺心病 呼吸衰竭 呼吸机相关肺炎 慢性肺源性心脏病 COPD 致病菌 

分 类 号：R541.5[医药卫生—心血管疾病]