酚妥拉明联合多巴酚丁胺治疗慢性肺心病心力衰竭合并呼吸衰竭120例疗效观察

To observe the therapy effect of phentolamine and dobutamine combined administration for the treatment of chronic cardiopulmonary disease complicated with heart failure and respiratory failure

目的观察酚妥拉明联合多巴酚丁胺治疗慢性肺源性心脏病(肺心病)心力衰竭合并呼吸衰竭的临床疗效。方法将240例患者按随机数字表分为两组,对照组120例采用控制感染、持续氧疗、改善通气及对症处理等常规治疗;观察组120例在常规治疗基础上联合酚妥拉明与多巴酚丁胺治疗。观察记录两组患者治疗前后临床症状、第1秒用力呼气容积(FEV1)和心脏射血分数(EF)的变化情况。结果总有效率治疗组为95.0%,对照组为74.2%,差异有统计学意义(P<0.01);两组治疗后FEV1和EF与治疗前比较均有增加,差异有统计学意义(P<0.05),且观察组的增加较对照组更显著(P<0.05、P<0.01)。结论酚妥拉明联合多巴酚丁胺治疗慢性肺心病心力衰竭合并呼吸衰竭疗效显著,值得临床试用。

Objective To observe the clinical therapy effect of phentolamine and dobutamine combined administration for chronic cardiopulmonary disease complicated with heart failure and respiratory failure. Methods 240 patients of chronic cardiopulmonary disease complicated with heart and respiratory failure were enrolled and randomly divided into the observation group （n = 120） and the control group （n = 120）. The control group received controlling of respiratory tract infections, continuous low flow oxygen inhalation, keeping respiratory tract from impeding and the routine treatment for improving respiratory function and correcting hypoxia. The observation group was administered with phentolamine and dobutamine in intravenous way based on the routine treatments. Results The effective rate of observation group was statistically higher than that of the control group（95.0% vs 74.2% ,P 〈 0.01 ）. After treat- ment,the forced expiratory volume in one second（ FEV1 ） and ejection fraction （EF） of the two groups were significantly increased compared with the baseline （ P 〈 0.05 ）. The observation group demonstrated better therapeutic effects of FEV1 （ P 〈 0.05 ） and EF （P 〈 0.01 ） than those in the control group. Conclusion Combined administration of phentolamine and dobutamine showed notable curative effect in patients with chronic cardiopulmonary disease complicated with heart and respiratory failure ; it is worth of clinical application.