慢性肺源性心脏病合并右心衰竭容量管理与治疗的研究进展
Research Advances in Volume Management and Treatment of Chronic Cor Pulmonale Complicated with Right Heart Failure
DOI: 10.12677/acm.2026.1641730, PDF,   
作者: 图尔迪麦麦提·阿卜杜麦麦提：新疆维吾尔自治区和田地区墨玉县人民医院呼吸与危重症医学科，新疆 和田；新疆医科大学第一临床医学院，新疆 乌鲁木齐；麦麦提托合提·萨迪克*：新疆医科大学第一临床医学院，新疆 乌鲁木齐；新疆维吾尔自治区和田地区墨玉县人民医院心血管内科，新疆 和田
关键词: 慢性肺源性心脏病；右心衰竭；肺动脉高压；容量管理；Chronic Cor Pulmonale； Right Heart Failure； Pulmonary Hypertension； Volume Management
摘要: 慢性肺源性心脏病(肺心病)是慢性呼吸系统疾病终末期的严重并发症，右心衰竭是其主要致死原因，而容量超负荷与体循环淤血是右心衰竭进展的核心病理环节，容量管理也成为肺心病合并右心衰竭全程治疗的基石。本文结合国内外最新指南与临床研究证据，系统阐述肺心病合并右心衰竭的病理生理机制，梳理容量状态的规范化评估体系，重点总结容量管理的核心策略与药物治疗的研究进展及争议，同时针对特殊临床场景的处理提出参考方案，最后分析当前诊疗中存在的问题与未来研究方向，旨在为临床规范化诊疗提供理论依据与实践参考。
Abstract: Chronic cor pulmonale is a devastating, life-limiting complication of end-stage chronic respiratory diseases, and right heart failure represents the leading cause of mortality in affected patients. Volume overload and systemic venous congestion constitute the core pathophysiological drivers of right heart failure progression, establishing volume management as the fundamental cornerstone of holistic treatment for Chronic cor pulmonale complicated with right heart failure. In this review, we synthesize the latest domestic and international clinical guidelines and high-quality clinical research evidence, systematically elucidate the pathophysiological mechanisms underlying Chronic cor pulmonale-related right heart failure, outline the standardized assessment framework for volume status, and predominantly summarize the core strategies of volume management as well as research advances and unresolved controversies in pharmacotherapy. Meanwhile, we propose evidence-based reference management protocols for special clinical scenarios, and conclude by analyzing existing limitations in current clinical practice and promising future research directions. This work aims to provide a solid theoretical basis and practical reference for the standardized clinical diagnosis and management of Chronic cor pulmonale complicated with right heart failure.
文章引用：图尔迪麦麦提·阿卜杜麦麦提, 麦麦提托合提·萨迪克. 慢性肺源性心脏病合并右心衰竭容量管理与治疗的研究进展 [J]. 临床医学进展, 2026, 16(4): 4586-4593. https://doi.org/10.12677/acm.2026.1641730

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