重症充血性心力衰竭院前急救对策及远期疗效观察

Emergent and long-term therapy and effect of patients with worse congestive heart failure

目的 观察重症充血性心力衰竭 (CHF)近远期治疗效果。方法 对 10 5例重症充血性心力衰竭病人急性加重期采用硝普钠或压宁定合并小剂量多巴胺持续泵入 ,心功能改善后进入远期治疗 ,根据个体差异逐渐调整悦宁定、倍它乐克剂量至最大耐受量 ,安体舒通、双氢克尿噻小剂量应用。随访观察两年。结果 对重症CHF急性加重期、长期治疗随访结果显示 ,心功能明显改善 (P <0 0 0 1) ,住院次数、住院时间较正规治疗前明显下降 (P <0 0 0 1) ,病死率下降。悦宁定与安体舒通长期联合应用具有良好的耐受性。结论 把握及时有效的近期治疗及重视正规的远期治疗可有效的改善心功能 ,提高生存质量。

Objective To investigate the therapeutic effect on patients with worse chronic congestive heart failure.Methods 105 patients with worse congestive heart failure were initially received Sodium Nitroprusside or Urapidil micropumped with low dose of Dopamine.Those patients transferred to long-term combined use of triamterene and hydrochlorothiazide with tolerant dose of enalapril and metoprolol individually after improvement of their clinical situation and were followed-up for two years.Result The cardiac function of patients with worse heart failure were significantly improved(P<0.001)with lowed hospitalization and reduced fatality rate.The combined use of triamterene and enalapril was well tolerant.Conclusion The well performed emergent and long therapeutic methods can effectively improved cardiac function and the quality of life.