多巴胺速尿持续静注在治疗老年急性心肌梗死合并泵功能不全中的临床应用

Clinical application of continuous intravenous treatment of Dopamine and Furosemide in elderly patients with acute myocardial infarction complicating pump function insufficiency

目的观察多巴胺、速尿应用微泵持续静注在治疗老年急性心肌梗死(AMI)合并泵功能不全的临床效果。方法将42例老年AMI合并泵功能不全患者分为观察组(22例)和对照组(20例),对照组应用西地兰及速尿间断静注治疗,观察组应用多巴胺、速尿微泵持续静注治疗。比较两组治疗前及治疗后48 h的心率、平均动脉压(MBP)、尿量及中心静脉压(CVP)的情况。结果观察组在总有效率为90.9%,明显优于对照组(75.0%)(P<0.05),并且观察组在用药后对MBP影响及利尿的效果明显优于对照组(P<0.05或P<0.01)。结论多巴胺速尿持续静注治疗老年AMI合并泵功能不全,合理有效,泵功能级别明显改善,应用过程中血压平稳,也无其他明显不良反应,有较好的近期疗效,是一种有较高临床价值的治疗方法。

Objective To observe the clinical effects of applying continuous intravenous treatment of Dopamine and Furosemide in elderly patients with acute myocardial infarction （AMI） complicating pump function insufficiency. Methods 42 cases of AMI complicating pump function insufficiency were divided into observation group （22 cases） and control group （20 cases）, The control group was applied with intermittent intravenous therapy of Cedilanid and Furosemide, and the observation group was applied with continuous intravenous treatment of Dopamine and Furosemide. Heart rate, mean arterial blood pressure （MBP）, urine output and central venous pressure （CVP） were compared between the two groups before treatment and after 48-hour treatment. Results In the observation group, the efficiency was significantly higher when compared with the control guoup （90.9% vs 75.0%,P 〈 0.05）. And the effect on MBP and diuresis after administration in observation group was significantly better than that in the control group （P 〈 0.05 or P 〈 0.01）. Conclusion The continuous intravenous treatment of Dopamine and Furosemide in AMI suffering with heart failure is reasonable and effective, and the pump functional level is improved significantly. Moreover, during the treatment of continuous intravenous treatment of Dopamine and Furosemide, there are stable of the blood pressure, better recent efficacy and without other adverse reactions, which means this treatment has a high clinical value.