重度心力衰竭患者持续静脉泵入大剂量呋塞米的临床疗效观察

CHINA MEDICINE AND PHARMACY Vol.9 No.13 July 2019

221 2019年7月第9卷第13期·临床研究·

重度心力衰竭患者持续静脉泵入

大剂量呋塞米的临床疗效观察

丁茜萍??熊纭辉

深圳市宝安人民医院 （集团）第三人民医院，广东深圳 518103

[摘要]?目的?观察持续静脉泵入大剂量呋塞米在重度心衰患者治疗中的临床疗效。 方法?选取2016年1月～2018年1月在我院内科就诊的42例重度心衰患者，通过随机数字表法分为对照组（21例）与实验组（21例），对照组常规静脉推注呋塞米，实验组持续静脉泵入大剂量呋塞米。比较两组患者临床治疗效果，低血钾发生率，症状消失时间，治疗前、后心脏功能指标。 结果 实验组患者临床治疗总有效率为95.24%，低血钾率为0，对照组患者临床治疗总有效率为71.43%，低血钾率为19.05%，差异具有统计学意义（P ＜0.05）。两组患者治疗前心脏功能指标较差，差异无统计学意义（P ＞0.05），治疗后实验组心脏功能指标明显高于对照组，且实验组患者症状改善时间明显少于对照组，差异具有统计学意义（P ＜0.01）。实验组低血压发生率显著低于对照组，差异有统计学意义（P ＜0.05）。 结论 在重度心衰患者中，采取持续静脉泵入大剂量呋塞米治疗，可明显提高临床治疗效果，减少低血钾发生率，缩短临床症状消失时间，改善治疗后心脏各项功能指标，效果理想，值得临床推广。

[关键词]?重度心衰；持续静脉泵入；大剂量呋塞米；低血压

[中图分类号]?R541.6???[文献标识码]?A???[文章编号]?2095-0616（2019）13-221-03

Observation on clinical curative effects of continuous intravenous infusion of high-dose furosemide in patients with severe heart failure DING?Qianping??XIONG?Yunhui??

Third People's Hospital of Baoan People's Hospital (Group), Guangdong, Shenzhen 518103, China

[Abstract] Objective To observe and analyze the clinical curative effects of continuous intravenous infusion of high-dose furosemide in patients with severe heart failure. Methods 42 patients with severe heart failure who were treated in department of medicine in our hospital from January 2016 to January 2018 were selected. According to the random number table method, they were pided into the control group (21 cases) and the experimental group (21 cases). The control group was given routine intravenous infusion of furosemide while the experimental group was given continuous intravenous infusion of high dose furosemide. The clinical curative effects, the incidence of hypokalemia and the disappearance time of symptoms of the two groups were compared. Cardiac function indexes were compared before and after treatment. Results The total effective rate of clinical treatment in the experimental group was 95.24%, and incidence of hypokalemia was 0. The total effective rate of clinical treatment in the control group was 71.43%, and incidence of hypokalemia was 19.05%. The difference was statistically significant (P ＜0.05). The cardiac function indexes before treatment were poor in the two groups, and the difference was not statistically significant (P ＞0.05). After treatment, the cardiac function index of the experimental group was significantly higher than that of the control group, and the improvement time of symptoms in the experimental group was significantly shorter than that of the control group. The difference was statistically significant (P ＜0.01). The incidence of hypotension in the experimental group was significantly lower than that in the control group, and the difference was statistically significant (P ＜0.05). Conclusion In patients with severe heart failure, continuous intravenous infusion of high-doses furosemide can significantly improve the clinical curative effects, reduce the incidence of hypokalemia, shorten the disappearance time of clinical symptoms and improve cardiac function indexes after treatment. The curative effect is ideal and it worthy of clinical promotion.

[Key words] Severe heart failure; Continuous intravenous infusion; High-dose furosemide; Hypotension

多种因素作用下，因心脏泵血功能发生异常，

心输出量绝对减少或相对不足，无法满足机体组织

细胞代谢需求，引起血氧供应不足、呼吸障碍，以进

展速度快、病情凶险为特点，是一种常见的危急重症，对患者的生命造成严重威胁[1-2]。根据严重程度可分为轻度、中度、重度心力衰竭，而完全失代偿，心功能四级，静息状态下即有明显心力衰竭症状和体征即为重度心衰[3]。呋塞米是改善心衰症状