不同剂量呋塞米持续静脉泵入治疗心衰的效果分析

Analysis of the Effect of Different Dose Furosemide Continuous Intravenous Pump in the Treatment of Heart Failure

目的探究在应用不同剂量的呋塞米持续泵入的手段治疗心衰的临床效果。方法随机选择该院2015年1月—2016年12月前来就诊心功能Ⅳ级患者120例,随机分为4组各30例,所有患者均实施呋塞米持续静脉泵入治疗,而各组患者用药的剂量不同。A组患者4 mg/h,B组患者6 mg/h,C组患者10 mg/h,D组患者20 mg/h。分析对比4组患者临床疗效、尿量、血钾水平、乳酸水平及血碳酸根水平等。结果 B组尿量为(1 238.13±218.33)m L/d,C组(3 913.73±903.22)m L/d,D组(4 828.35±842.36)m L/d,均显著高于A组患者尿量;C组血钾水平为(3.25±0.52)mmol/L,D组(3.04±0.48)mmol/L,显著高于A组和B组患者;C组患者的乳酸降低水平为(2.19±0.84)mmol/L,血碳酸根水平升高(6.17±0.10)mmol/L与D组比较差异有统计学意义(P<0.05)。结论临床上20 mg/h的呋塞米检测到可降低血钾,10 mg/h的剂量在B超各项指标中均表现出较好的效果,因而进行10 mg/h的剂量呋塞米持续静脉泵入可起到更理想的效果,同时安全性较高。

Objective This paper tries to explore the clinical effect of using different doses of furosemide for continuous treatment of heart failure. Methods From January 2015 to December 2016, 120 patients with grade Ⅳ cardiac function were randomly divided into four groups, with 30 patients in each group. All patients were treated with furosemide continuous intravenous pump, and for each group of patients, the dosage of the medication is different. Group A of 4 mg/h, group B of 6 mg/h, group C of 10 mg/h, group D of 20 mg/h. The clinical efficacy, urine volume, serum potassium level, lactic acid level and blood carbonate level were compared and analyzed. Results Group B of urine output was（1 238.13±218.33） mL/d,group C of（3 913.73±903.22）mL/d, group D of（4 828.35±842.36）mL/d, were significantly higher than group A of patients with urine output of（3.25±0.52）mmol/L, group D of（3.04±0.48）mmol/L, significantly higher than group A and group B of patients; the third patient＇s lactate reduction level was（2.19±0.84）mmol/L, and the level of blood carbonate of（6.17±0.10）mmol/L was significantly different from that of the group D（P〈0.05）. Conclusion The dose of furosemide 20 mg/h can reduce the serum potassium,10 mg/h dose in the B-indicators have shown a good effect, and thus 10 mg/h dose of furosemide continuous intravenous pump into the more desirable effect, with higher security.