左心房导管输注去甲肾上腺素联合多巴胺对心力衰竭合并重度肺动脉高压患者的抢救效果观察

Effect of left atrial catheter infusion of norepinephrine and dopamine in the treatment of patients with heart failure combined with severe pulmonary hypertension

目的:观察左心房导管输注去甲肾上腺素联合多巴胺对心力衰竭合并重度肺动脉高压患者的抢救效果,探讨其临床适用性。方法:选择2014-03-2016-10于我院就诊的116例心力衰竭合并重度肺动脉高压患者,随机住院号法分为观察组58例和对照组58例,对照组给予多巴胺抢救,观察组联合左心房导管输注去甲肾上腺素治疗。观察2组患者的治疗效果,治疗前后心功能改善情况,肺动脉压治疗效果,治疗前后血BNP改善情况。结果:观察组与对照组的治疗有效率比较,差异有统计学意义(96.55%vs.84.48%,P<0.05);2组患者治疗前LVEF、LVDD、SV、CO及E/A比较,差异均无统计学意义,治疗后均改善(P<0.05),且观察组患者的各项心功能指标改善情况均明显优于对照组,差异有统计学意义(P<0.05)。2组患者治疗前肺动脉压及BNP比较,差异均无统计学意义,治疗后,肺动脉压和BNP均显著下降,差异有统计学意义(P<0.05),且观察组患者肺动脉压和BNP水平均显著低于对照组(P<0.05)。结论:左心房导管输注去甲肾上腺素联合多巴胺对心力衰竭合并重度肺动脉高压治疗效果更佳,在抢救过程中对心肺功能均有显著改善,适合临床长期推广应用。

Objective：To analyze the effect of left atrial catheter infusion of norepinephrine and dopamine in the treatment of patients with heart failure combined with severe pulmonary hypertension.Method：One hundred and sixteen patients with heart failure combined with severe pulmonary hypertension were selected from March 2014 to October 2016 in our hospital,and they were divided into the observation group and the control group,each with 58 patients.The patients in the control group were treated with dopamine,and the patients in the observation group were treated by dopamine combined with left atrial catheter infusion of norepinephrine.The therapeutic effect,the improvement of heart function and the pulmonary artery pressure,and the change of blood BNP before and after treatment were observed.Result：The effective rate was 96.55%in the observation group and 84.48%in the control group,and the difference was statistically significant（P〈0.05）.There were no significant differences in LVEF,LVDD,SV,CO and E/A between the two groups before treatment,but they were improved after treatment（P〈0.05）.The improvement of the cardiac function indexes in the observation group were significantly better than the control group,and the differences were statistically significant（P〈0.05）.There were no significant difference in pulmonary artery pressure and BNP between the two groups before the treatment.However,the pulmonary artery pressure and BNP were significantly decreased after treatment（P〈0.05）,and the pulmonary artery pressure and BNP levels in the observation group were significantly lower than those in the control group,and the difference was statistically significant（P〈0.05）.Conclusion：It is better for heart failure patients with severe pulmonary hypertension to be treated by left atrial catheter infusion of norepinephrine combined with dopamine.And it is worth to be applied in clinic.