不同剂量呋塞米持续静脉泵入治疗心衰的效果评价

Evaluation on the effect of continuous intravenous infusion of furosemide at different doses in the treatment of heart failure

目的评价对心衰予以不同剂量呋塞米持续静脉泵入治疗的临床效果。方法选取我院收治的心功能Ⅳ级120例患者为研究对象,随机分为四组,每组30例。所有患者均予以呋塞米持续静脉泵入治疗,每组患者的服用剂量不同,且<600 mg为每日的总剂量。比较分析四组患者的临床治疗效果。结果呋塞米剂量越大,尿量指标、心功能改善1级时间、血钾、血碳酸氢根与血乳酸指标改善效果越显著;四组患者B超指标(CI、SV、CO、LVEF)比较,C组稍高(P<0.05),A、D组间差异不明显(P>0.05)。但D组血钾浓度低于正常浓度范围,发生了低钾血症,C组剂量治疗效果最佳。结论由于20 mg/h呋塞米容易降低血钾浓度,因此,在临床治疗中,选用10 mg/h呋塞米进行持续静脉泵入治疗,治疗效果良好,具有较高的安全性。

Objective To evaluate the clinical effects of continuous intravenous infusion of furosemide at different doses on heart failure. Methods One hundred and twenty patients with heart function grade Ⅳ were randomly divided into four groups, with 30 cases in each group. All patients were treated with continuous infusion of furosemide, with different doses in each group, and 〈600 mg was the total daily dose. The clinical effects of the four groups were analyzed and compared. Results The higher the dose of furosemide, the better the urine output, the time of heart function improvement and the level of blood potassium, blood bicarbonate and blood lactate. The B ultrasonic indicators （CI, SV, CO, LVEF） in the group C were higher among the four groups （P〈0.05）, and there was no significant difference between the group A and D （P〉0.05）. But the serum potassium level of the group D belowed the normal range, and occurred hypokalemia, the dose of the group C had the best treatment effect. Conclusion Owing to 20 mg furosemide is prone to reduce serum potassium level, therefore the choice of 10 mg/h furosemide for continuous intravenous infusion therapy has a good treatment effect and high security in clinic.