慢性肺心病并发低渗血症61例临床分析

CLINICAL ANALYSIS OF 61 CASES OF LOW OSMOTIC PRESSURE OF THE BLOOD COMPLICATED WITH CHRONIC COR PULMONALE

目的：研究慢性肺心病急性发作期并发低渗血症的诊断、病因、治疗及预后。方法：对我院１９９５ 年１１ 月至１９９７ 年１０ 月慢性肺心病住院患者１７５ 例临床资料进行分析，用公式法计算血浆渗透压。诊断：血浆渗透压＜ ２８０ｍｏｓｍ／Ｌ，在综合治疗基础上，经提高晶体渗透压后病情迅速改善者。病因：是多方面的。治疗：主要是补充钠盐，提高晶体渗透压。预后：与血浆渗透压下降程度和发展速度密切相关。结果：１７５ 例慢性肺心病住院患者中，６１ 例并发低渗血症（３４ ．８６ ％ ） ，轻度２５ 例（４０ ．９８ ％ ） ，中度１９ 例（３１ ．１５ ％ ） ，重度１７ 例（２７ ．８７ ％ ） 。治愈４６ 例，死亡１５ 例（２４ ．５９ ％ ） 。结论：慢性肺心病急性发作期可因多种原因引起低渗血症，主要的治疗方法是补充钠盐。低渗血症越严重，发展越快，预后越差。

Objective:To study the dia gnosis,etiology,trestment and prognosis for the low osmotic pressure of the blood complicated with chronic cor pulmonale during acute attact. Method:Analize the clinical data of 175 patients in hospital with chronic cor pulmonale and calculate the osmotic pressure of the blood in formula.Diagnosis:after the patients with osmotic pressure of the blood<280 mosm/L are treated synthelicaly,the crystal osmotic pressure is raised.Theetiology is varied.Treatment:Mainly to add sodium salt to raise the crystal osmotic pressure. Prognosis:the degree of decending theosmotic pressure of the blood is closely connected with the developing speed.Result:Among 175 patients in hospital with chronic cor pulmonale,61 patients with low osmotic pressuer of the blood(34.86%),mild 25cases (40.98%),modereate 19 cases(31.15%),severe 17 cases(27.87%).46 patients are cured,15 patients died(24.59%).Conclusion:Chronic cor pulmonale during acute attact can cause low osmotic pressure of the plood for varied reasons.The way of treating is to add sodium salt.Themore serious the low osmotic pressure of the blood is,the fast it develops and the worse the prognosis is .