慢性肾功能衰竭患者血液透析后并发急性心衰临床探究

目的探讨联合使用缬沙坦与左卡尼汀对慢性肾功能衰竭患者血液透析后并发急性心力衰竭的影响。方法选择2009年3月一2011年3月在我院血液透析中心进行透析的患者64例，随机分为研究组32例，对照组32例，研究组在进行血液透析前2周维持服用缬沙坦80—160mg，1次／d，左卡尼汀3g加入0．9％氯化钠注射液100ml中静滴，3次／周，对照组不设预防用药，两组在出现急性左心衰的时候均给予相同的抢救措施，并且实施紧急血液透析治疗。观察死亡率，有效率，血压的情况。结果研究组急性心力衰竭控制有效率可达93．8％，死亡率控制在21．5％，血压控制在160—192／105—128mmHg。结论1．使用缬沙坦联合左卡尼丁可以有效的降低急性左心衰的发生率；2．配合紧急血液透析治疗，可以快速提高抢救成功率。

Objective to investigate the use of valsartan combined with Levocarnitine in patients with chronic renal failure on hemodialysis complicated with acute heart failure effects. Methods March 2009-March 2011 in our hospital dialysis center dialysis 64 patients were randomly divided into study group of 32 patients in the control group of 32patients, the study group during the 2 weeks before hemedialysis to maintain the sand taking Valerian Tan 80 - 160mg, 1 times / d, L-carnitine 3g in 0.9% sodium chloride injection 100ml intravenously, 3 times / week, the control group without prophylaxis, the two groups in acute left heart failure the same time were given the rescue measures, and implementation of emergency hemodialysis. Observed mortality rate, efficiency, blood pressure situation. Results The study group has effective control of acute heart failure up to 93.8% , control 21.5% mortality, blood pressure control in 160-192/105-128mmHg. Conclusion 1. Jie losartan combined with left-carnitine can effectively reduce the incidence of acute left heart failure; 2 with emergency dialysis treatment, can quickly improve the success rate.