Pulmonary heart disease is due to chronic diseases of bronchus and lung, thorax or pulmonary hypertension leading to pulmonary hypertension, right ventricular overloading, result in right ventricular hypertrophy, expand and even heart disease with right heart failure occurs, this disease for old people in common, often leading to lung, heart failure, severe pulmonary heart disease mortality is relatively high, a serious threat to the health of the elderly in. February 2003, we are using urokinase and heparin in the treatment of 36 cases of pulmonary heart disease combined, achieving more satisfactory results, are reported below:
1 data and methods
1.1 clinical information: pulmonary heart disease 36 cases, are meet 1971 national pulmonary heart disease meeting developed of diagnosis standard, which men 20 cases, and female 16 cases, age 42~76sui, average 61.5 aged, course 6-28 years, which ⅱ type respiratory failure 32 cases, and ⅰ type respiratory failure 4 cases, and ⅱ ° heart failure 14 cases, and ⅲ ° heart failure 22 cases, random select has 36 cases pulmonary heart disease patients as controlled group, two group treatment Qian are check blood analysis and the blood rheological learn indicators, by statistics processing no significantly differences.
1.2 treatments: will meet the diagnostic criteria in patients with Cor pulmonale observation group, control group randomly divided into, two groups are regular nasal oxygen, and rational use of antibiotics, cough and phlegm, relieving, symptomatic, nutrition, treatment. Treatment group apart from the conventional treatment given heparin subcutaneous injection of 50mg, 2 times daily, with 7~10d, intravenous infusion of urokinase 100,000 u, 1 times a day, 3~5d, review the blood gas analysis and hemorheology before and after treatment.
Result 1.3: comparison of treatment effect on two groups of patients as shown in table 1.
Table 1 comparison of two groups of blood-gas analysis and hemorheology indexes table (omitted)
Can be seen from table 1: treatment of groups of blood gas analysis value and blood rheology index than the control group had significant improvement, total effective rate higher than the control group.
2 nursing
2.1 medication Qian nursing: medication Qian to patients and families description medication purpose common complications, makes patients and families has psychological prepared, elimination concerns, enhanced patients beat disease of confidence, actively tie treatment makes nursing work to smooth for, asked patients has no bleeding sexual disease or digestive sexual ulcer, as has activities sexual hepatitis, control not satisfaction of hypertension, and heart lung recovery Hou, and diabetes merge retinal lesions and has allergy history who disabled, strictly implementation orders, accurate master medication dose, liver pigment for anticoagulant drug, urine kinase for dissolved suppository drug, two species drug dosage more Shi, are will appears bleeding phenomenon, so daily injection Qian and the medication during are should for platelet count, and Thrombin original time and the Thrombin time determination.
2.2 in the course of medication: the dose to be accurate, urokinase is not diluted with acidic liquids, so as not to effect falling deactivation and dissolves easily, so it should be now active distribution. Monitoring blood gas analysis of blood routine periodic review every day, ask the patient Complete Bed Rest, avoid collisions or falls. Medication to enhance skin care, observation of skin mucous membrane with no bleeding, congestion under the skin, hemoptysis, gastrointestinal bleeding, massive hemoptysis should stop immediately, and get blood transfusion ready, strict observation of changes of vital signs, each 30min measuring temperature, pulse, breathing and blood pressure, unusual slow drip in a timely manner, inform the doctor.
2.3 General care: early in the anticoagulant therapy, patients still need bed rest. Avoid unnecessary turning, limit their relatives and friends visit, prevents emotional, guiding patients the correct medication, Diet, keep a normal bowel movement and, if necessary using a laxative.
2.4 do self care during treatment guide, bleeding is the main complications during treatment, observation with no bleeding tendency, observation of gums, skin and mucosal hemorrhage after spontaneous or puncture-free, there is no unexplained joint swelling or blood in the sputum.
2.5 do patients during hospitalization and discharge instructions are important incentives for teaching patients prevention hemorrhage, do not dig nose, do not use sharp razor, collision avoidance, etc. Monitoring of bleeding signs, observation of mucosa of nasal, systemic, obey the color in time find some complications can be handled in a timely manner.
3 discussion
Pulmonary heart disease people because hypoxia stimulation kidney produced promoting erythrocyte generated pigment, which stimulation bone marrow makes erythrocyte generated increased, blood viscosity consistency increased, coupled with hypoxia and makes vascular endothelial cell injury and the right heart failure induced blood static easy merge pulmonary thrombosis formation, liver pigment and urine kinase pigment joint application, is can will low blood viscosity consistency, and can dissolved pulmonary thrombosis, thus improve has lung blood flow, conducive to oxygen hop of improve, provides has pulmonary heart disease treatment of new concept, this group information display treatment group of total effective rate more controlled group obvious improve, blood analysis and the blood rheological learn of improve obvious good Yu controlled group and no serious bad reaction, description anticoagulant and dissolved suppository is treatment pulmonary heart disease of effective method one.