持续静脉速尿并多巴胺微量泵入在老年危重心衰患者中的应用

The Application of Ferosemide and Dopamine by Microinfusion Pump Continually to Severe Heart Failure in Elder Patients

目的：探讨速尿并多巴胺持续微量泵人对老年危重心力衰竭的疗效。方法：入选对象共49例，均为NYHA标准Ⅲ～Ⅳ级心力衰竭患者，按先后顺序，查随机排列表分为两组，即持续静脉微量泵注入速尿并多巴胺（观察组。25例）和反复多次静脉注射速尿（对照组，24例）。观察组给予速尿120mg，多巴胺40mg加入微量泵持续注入24h；对照组则静脉6h推注速尿40-80mg。治疗前和治疗48h后分别检测电解质，治疗中检测血压，并计算24h、48h尿量。结果；持续静脉泵注速尿并小剂嚣多巴胺在24h及48h后统计尿量明显高于多次性速尿注射,观察组尿量显著高于对照组（P〈0．01），48h中平均血压波动差值比较观察组明显小于对照组（P〈0．05），且血压波动幅度减小，两组电解质比较无统计学差异（P〉0．05），患者水肿明显减轻，胸闷，气促症状改善。结论；持续静脉泵注速尿并小剂量多巴胺在老年危重心衰的疗效明显高于多次性速尿静脉注射。

Objective： To investigate the effect of furosemide and dopamine by microinfusion pump in elderly severe heart failure. Methods： Forty-nine elderly patients with severe heart failure（NYHA class III or IV ） were randomly assigned into group A （25 cases ） and group B （24 cases）. The patients in group A were microinfused with furosemide at 120 mg and dopamine at 40 mg continually everyday, while the ones in group B infused with furosemide at 40--80 mg every 6 hours. Electrolyte in blood was measured pretreatment and at 48 hours after treatment, respectively. Blood pressure was measured during treatment. Urine volume was measured in 24 hours and 48 hours. Results：Urine volume was larger in group A in 24 hours and 48 hours （P〈0.01）, the range of fluctuant blood pressure lower than that jin group B, whereas electrolyte was no defferent between the two groups. Symptoms such as edema, chest pressure and dyspnea improved in Group A. Conlusion： Ferosemide and dopamine microinfused continurally are better than ferosemide only discontinuously injected.