硝普钠泵入治疗顽固性心力衰竭的优势

The advantages of sodium nitroprusside continuous intravenous infusion in the treatment of refractory heart failure

目的探讨我院近两年来以硝普钠持续静脉泵入治疗顽固性心力衰竭的疗效。方法将58例经合理给予洋地黄、利尿剂、转换酶抑制剂、硝酸酯类药物、纠正病因诱因、吸氧等治疗仍无效或加重的顽固性心力衰竭患者,用微量输液泵给予硝普钠持续静脉泵入,避光使用,疗程5 d。结果与治疗前比较,治疗后每搏输出量(SV)、每分输出量(CO)、左室射血分数(EF)、6 min步行距离均有显著增加(P<0.05);心胸比值、左室舒张末径(LDV)缩小(P<0.05)。58例显效41例(70.69%),有效17例(29.31%),总有效率100%。结论微量输液泵持续泵入硝普钠治疗顽固性心力衰竭疗效显著。特别适用于高血压性心脏病、以关闭不全为主的心瓣膜病、先天性心脏病、冠心病、扩张型心肌病等合并的顽固性心衰。起效快、方便易行,安全度高,值得临床推广。

Objective To explore the efficacy of sodium nitroprusside continuous intravenous infusion in the treatment of refractory heart failure in the past two years of our hospital. Methods Fifty-eight cases of patients with refractory heart failure who still ineffective or aggravated by reasonablely given digitalis, diuretics, converting enzyme inhibitors, nitrates, correction of the incentives causes and oxygen inhalation, were given sodium nitroprusside continuous intravenous infusion with a micro-infusion pump under dark for 5 days. Results Compared with before treatment, stroke volume （SV）, output per minute （CO）, left ventricular ejection fraction （EF）, 6 minute walk distance after treatment were significantly increased （P 〈 0.05）; cardiothoracic ratio and left ventricular end diastolic diameter （LDV） were narrowing （P 〈 0.05）. Among 58 cas- es of patients, 41 cases were significantly effective （70.69%）, 17 cases effective （29.31%）, and the total efficiency was 100%. Conclusion Sodium nitroprusside continuous intravenous infusion with micro-infusion pump in the treatment of re- fractory heart failure has significant efficacy. It is particularly suitable for refractory heart failure combined with hyperten- sive heart disease, regurgitation-based heart valve disease, congenital heart disease, coronary heart disease, dilated car- diomyopathy. It takes effect quickly, performs easily with high safety, and it is worthy of clinical promotion.