慢性肺源性心脏病合并肺血栓栓塞致顽固性右心衰竭36例临床分析

目的探讨慢性肺源性心脏病（chronicpulmonaryheartdisease，CPHD）合并肺血栓栓塞（PTE）致顽固性右心衰竭的临床特点和诊治方法。方法回顾性分析住院36例肺心病顽固性右心衰竭患者的临床资料，经CT肺动脉造影（CTPA）确诊合并PTE，其中25例存在血流动力学障碍，给予溶栓抗凝治疗；11例无血流动力学障碍，单纯应用抗凝治疗。结果36例经溶栓和（或）抗凝治疗后，好转33例，3例死于呼吸衰竭及顽固性右心衰竭。结论肺心病合并肺血栓栓塞易致顽固性右心衰竭，临床表现不典型，易被原发病及并发症掩盖，漏诊率高，应引起临床重视。

Clinical research of 36 intractable right ventricular heart failure patients caused by chronic pulmonary heart disease combining pulmonary

Objective To observe the clinical findings and therapy procedure of intractable right ventricular heart failure patients caused by chronic pulmonary heart disease combining pulmonary thromboembolism. Methods Thirty-six intractable right ventricular heart failure patients caused by chronic pulmonary heart disease were obseved, all were confirmed by CTPA to have pulmonary thromboembolism,25 of the patients had dynamic obstacles blood flow and received therapy of anticoagulation and thrombolysis,the other 11 only received anti- coagulation. Results After therapy,33 patients bettered,3 died of respiratory failure or intractable right ventricular heart failure. Conclusion Pulmonary heart disease combining pulmonary thromboembolism can often cause intractable right ventricular heart fail- ure, the patients don＇t have classic clinical findings, the symptoms can be covered by basic disease, the disease can often be misdiagnosed and should he paid more attention.