持续静脉微量注射呋塞米对严重充血性心力衰竭患者治疗效果

The application of furosemide by microinfusion pump continually in severe congestive heart failure

目的观察对比持续静脉微量注射呋塞米对严重充血性心力衰竭(CHF)患者疗效是否优于传统的间断注射疗效。方法在常规防重构、强心、扩血管的基础上,观察分析72例NYHA心功能Ⅲ-Ⅳ级患者,分为持续静脉微量注射呋塞米组(观察组)35例和间断注射呋塞米组(对照组)37例,两组使用呋塞米剂量大致相同,比较两组治疗前后尿量、血压波动、血液电解质浓度、超声心动图心功能指标、症状缓解时间和水肿消退时间的差别。结果观察组治疗后尿量多于对照组,心功能指标FS和LVEF改善显著优于对照组,症状缓解时间和水肿消退时间短于对照组(P<0.01或0.05);血压和血液电解质浓度无显著差异(P>0.05)。结论持续静脉微量注射呋塞米治疗严重CHF,疗效明显优于传统的间断静脉注射法。

Objective To investigate the effect of furosemide by microinfusion pump in severe congestive heart failure （CHF）. Methods Under the anti-remodeling, cardiotonic and vasodilator treatment, seven-two patients with severe CHF （NYHA class Ⅲ or Ⅳ） were assigned into group A （35 cases） and group B （37 cases）. The patients in group A were microinfused with furosemide continually everyday,while the ones in group B bolus infused discontinuously with furosemide at same dosage everyday. Electrolyte in blood was measured pretreatment and after treatment, respectively. Blood pressure and urine volume was measured during treatment. Results Urine volume was larger in group A after treatment （P〈0.01 or 0.05）, cardiac function FS and LVEF improved in Group A （P〈0.05）, the range of fluctuant blood pressure lower than that in group B, whereas electrolyte was no different between the two groups （P〉0.05）. Symptoms such as edema, chest pressure and dyspnea improved in Group A （P〈0.05）. Conlusion Furosemide microinfused continuraUy are better than furosemide only discontinuously bolus injected.