多巴胺联合硝普钠持续静脉泵入治疗老年顽固性心衰的治疗效果及对心功能的影响

The effect of continuous intravenous infusion of dopamine combined nitroprusside in the treatment of elderly with refractory heart failure and its effect on cardiac function

目的 探讨多巴胺联合硝普钠持续静脉泵入治疗老年顽固性心衰的治疗效果及对心功能的影响。方法选择我院2014年6月~2015年11月收治的78例老年顽固性心衰患者为研究对象,以随机数字表法分为观察组39例和对照组39例,对照组接受常规方案联合多巴胺治疗,观察组在常规方案基础上实施多巴胺联合硝普钠持续静脉泵入治疗,对两组治疗效果及心功能、基础指标变化进行观察。结果 观察组总有效率为94.87%,对照组为84.62%,两组差异有统计学意义（P〈0.05）;治疗前两组患者呼吸、心率、收缩压、舒张压等基础指标无明显差异（P〉0.05）,观察组治疗后各指标均优于对照组,差异有统计学意义（P〈0.05）;治疗前两组患者左室舒张末期内径、左室收缩末期内径、每搏指数、每搏输出量、左室射血分数等指标均无明显差异（P〉0.05）,观察组治疗后各项心功能参数水平均优于对照组,差异有统计学意义（P〈0.05）。结论 多巴胺联合硝普钠应用于老年顽固性心衰治疗中具有显著疗效,能改善心功能,具有可行性,值得临床推广。

Objective To investigate the clinical effect of continuous intravenous infusion of dopamine combined nitro- prusside in the treatment of elderly with refractory heart failure and the effect on cardiac function. Methods 78 elderly patients with refractory heart failure in hospital from June 2014 to November 2015 were included and divided into the observation group and the control group with 39 cases in each by random number table. Patients in the control group were treated by conventional scheme combined with dopamine, while in the observation group were treated by conven- tional scheme combined with Continuous intravenous infusion of dopamine and nitroprusside. The therapeutic effect, changes on cardiac function and basic indicators were observed. Results The total efficiency rate in the observation group was 94.87%, while in the control group was 84.62%, the difference was statistically significant （P〈O.05）. Before treatment, there were no significant differences of respiratory rate, heart rate, systolic blood pressure, diastolic blood pressure and other basic indicators in 2 groups（P〉0.05）. After treatment, indicators above in the observation group were better than those in the control group, the differences were statistically significant（P〈0.05）. Before treatment, there were no significant differences of left ventricular end diastolic diameter, left ventricular end systolic diameter, stroke index, stroke volume, left ventricular ejection fraction and other indicators in 2 groups（P〉0.05）. After treatment, indicators above in the observation group were better than those in the control group, the differences were statistically significant（P〈0.05）. Conclusion Dopamine combined nitroprusside in the treatment of elderly patients with refractory heart failure treatment has significant effect, which can improve cardiac function feasibly, it is worth the clinical pro- motion.