超滤脱水装置在顽固性心衰患者中的应用

Application of Ultrafiltration Dehydration Device in Patients with Refractory Heart Failure

目的:研究探讨超滤脱水装置在顽固性心衰患者治疗中的应用效果。方法:选取我院近3年收治的顽固性心衰患者70例为研究对象,采用超滤脱水装置进行超滤治疗。持续治疗4周以后,对患者的临床疗效进行观察评价,并对患者的治疗前后的基础生理指标包括患者的心率、体重、平均动脉压进行检测比较,以及患者的心功能、肾功能指标的改善情况。结果:(1)本研究中超滤法治疗顽固性心衰患者的临床总有效率为97.14%(68/70),临床疗效显著。(2)治疗后患者的心率、体重、医学研究会呼吸困难量表(medical research council scale,MRC)分别为(94.12±10.21)次/min、(65.97±6.89)Kg、(2.47±1.02)分,显著低于治疗前为(110.67±11.83)次/min、(71.73±7.93)Kg、(3.56±1.21)分,差异有统计学意义(P<0.05)。治疗前后患者的平均动脉压(mean arterial pressure,MAP)无显著变化。(3)治疗后患者的心功能指标包括心输出量、左室射血分数(Left ventricular ejection fraction,LVEF)、B型脑钠肽(brain natriuretic peptide,BNP)分别为(5.09±1.14)L/min、(48.92±8.31)%、(1486.34±197.95)pg/mL,显著优于治疗前分别为(2.32±1.01)L/min、(29.76±7.09)%、(3979.35±646.42)pg/mL,差异有统计学意义(P<0.05)。(4)患者治疗前后的肾功能指标包括肾小球滤过率(glomerular filtration rate,GFR)、肌酐(creatinine,Cr)、尿素氮(Blood urea nitrogen,BUN)等水平值无统计学差异,提示超滤前后不影响患者的肾功能。结论:应用超滤脱水装置对顽固性心衰患者进行超滤治疗的临床疗效显著,能够迅速缓解患者的症状,改善患者心功能,且操作简便,有较高的临床应用价值。

Objective： To study the effect of ultrafiltration dehydration device in the treatment of refractory heart failure patients. Methods： 70 patients with refractory heart failure treated in our hospital in recent 3 years were selected as the research objects, and ultrafiltration dehydration device was used for ultrafiltration treatment. 4 weeks later, observe and evaluate the clinical curative effects of the patients, and the physiological indexes of patients before and after treatment were compared in patients including heart rate, body weight, mean arterial pressure, and improve the renal function index of patients with cardiac function. Results： （1） the total effective rate of ultrafiltration in the treatment of refractory heart failure patients was 97.14% （68/70）, and the clinical efficacy was remarkable. （2） after the treatment of patients with heart rate, body weight, Medical Association Dyspnea Scale （Medical Research Council scale, MRC） respectively （94.12 ＋ 10.21）/min, （65.97 ＋ 6.89）Kg, （2.47 ＋ 1.02）min, was significantly!ower than that before treatment （110.67 ＋ 11.83）/min, （71.73 ＋ 7.93）Kg, （3.56 ＋ 1.21）min, the difference was statistically significant （P〈0.05）. The mean arterial pressure （mean, arterial, pressure, MAP） did not change significantly before and after treatment. （3） heart function indexes of patients after treatment, including cardiac output, left ventricular ejection fraction （Left ventricular ejection fraction, LVEF）, B - type natriuretic peptide （brain natriuretic, peptide, BNP） respectively （5.09 ＋ 1.14）L/rain, （48.92 ＋ 8.31）% and （1486.34 ＋ 197.95） pg/mL. Significantly better than before treatment respectively （2.32 ＋ 1.01）L/min, （29.76 ＋ 7.09）% and （3979.35 ＋ 646.42） pg/mL, the difference was statistically significant （P〈0.05）. （4） renal function indexes before and after treatment in patients with glomerular filtration rate （including glomerular filtration rate, GFR）, creatinine （creatinine, Cr）, blood urea nitrogen （Blood urea, nitrogen, BUN） there was no significant difference in the level of value, that does not affect the renal function of the patients before and after ultrafiltration can. Conclusion： The application of ultrafiltration device in patients with refractory heart failure clinical curative effect of ultrafiltration treatment significantly, can quickly relieve symptoms, improve heart function, and the operation is simple, has high value in clinical application.