老年人慢性心力衰竭伴低钠血症75例治疗分析

Treatment analysis of 75 cases of elderly chronic heart failure with hyponatremia

目的总结老年人慢性心力衰竭伴低钠血症的临床治疗经验。方法对75例65岁以上的老年人慢性心力衰竭(Ⅲ～Ⅳ级)伴低钠血症患者,除限水、扩张血管、强心治疗外,给予3%氯化钠及呋塞米治疗。比较治疗前后患者的心功能分级、疗效、血钠水平。结果75例患者治疗前后,心功能情况比较差异有显著的统计学意义(P<0.05);治疗后显效53例,有效16例,无效6例,总有效率92%;治疗后心功能Ⅲ级、Ⅳ级的血钠分别为(142.7±4.3)mmol/L、(141.8±4.8)mmol/L,与治疗前心功能Ⅲ级、Ⅳ级者的血钠分别为(125.1±3.1)mmol/L、(123.4±3.3)mmol/L比较,差异有统计学意义(P<0.05)。结论合理利尿、适当补充钠盐有助于减少老年人慢性心力衰竭伴低钠血症患者恶性事件发生的风险,改善患者预后。

Objective To summarize the clinical treatment experience in elderly chronic heart failure with hyponatremia. Methods Treated 75 patients who were suffering from elderly chronic heart failure, aging over 65 with hyponatremia ,with giving 3% sodium chloride and furosemide treatment, besides operating water ingestion limit,blood vessel expansion,myocardial contractility strengthening.h was compared the former heart function classification, effect, hyponatremia level with after treatment. Results After treatment, 75 patients＇ heart function level was obviously different compared with that before treatment. The difference had a statistics meaning （P〈0.05）. After treatment 53 patients have distinct effect,16 patients have certain effect,6 patients have no effect, and the total effective rate was 92%;After treatment the hyponatremia of patients who have different heart function were （142.7±4.3）retool/L, （141.8±4.8）mmol/L respectively. The difference has a statistics meaning （both P〈 0.05） compared with former hyponatremia which were （125.1±3.1）mmol/L and （123.4 ±3.3）mmol/L. Conclusion Proper diuresis and sodium salt supplement help reduce themalignant risk of the patients suffering from elderly chronic heart failure with the hyponatremia and improve the prognosis of patients.