慢性纤维空洞性肺结核导致的肺心病、心衰的临床对策

Clinical strategies for pulmonary heart disease and heart failure caused by chronic fibro-cavitary pulmonary tuberculosis

目的探析慢性纤维空洞性肺结核导致的肺心病、心衰的临床治疗方法，对临床治疗效果进行分析。方法选取2009年4月-2016年3月我科收治的60例慢性纤维空洞性肺结核导致的肺心病、心衰患者为主要研究对象，根据随机分配的原则将其分为对照组（n=30）和观察组（n=30）。对照组给予常规治疗，观察组在对照组的基础上添加硝普钠和多巴胺微量泵治疗，对两组患者的临床效果进行对比分析。结果观察组患者的临床治疗总有效率为93．33％，与对照组的70．0％相比差异有统计学意义（P〈0．05）；观察组患者的心衰症状改善时间与对照组相比差异显著（P〈0．05）；经治疗后，观察组患者的心率较治疗前、对照组相比有明显变化（P〈0．05），血压无明显变化。结论采用硝普钠和多巴胺微量泵治疗慢性纤维空洞性肺结核导致的肺心病、心衰效果显著，可缩短疾病症状改善时间，稳定血压、心率，值得在临床上进一步应用和推广。

Objective To investigate the chnical therapeutic methods for pulmonary heart disease and heart failure caused by chronic fibro-cavitary pulmonary tuberculosis and their clinical effects. Methods A total of 60 patients with pulmonary heart disease and heart failure caused by chronic fibro-cavitary pulmonary tuberculosis who were admitted to our department from April 2009 to March 2016 were enrolled and randomly divided into control group and observation group, with 30 patients in each group. The patients in the control group were given conventional treatment, and those in the treatment group were given sodium nitroprusside and dopamine micropump. The clinical outcome was compared between the two groups. Results The observation group had a significantly higher overall response rate than the control group （93.33% vs 70.0%, P〈0.05）. There was a significant difference in the time to relief of heart failure symptoms between the observation group and the control group （P〈0.05）. After treatment, the observation group had a significant change in heart rate and there was a significant difference between the two groups （P〈0.05）, while there was no significant change in blood pressure. Conclusion In the treatment of pulmonary heart disease and heart failure caused by chronic fibro-eavitary pulmonary tuberculosis, sodium nitroprusside and dopamine micropump has a good clinical effect and can shorten the time to relief of symptoms and stabilize blood pressure and heart rate. Therefore, it holds promise for clinical application.