持续静脉泵注多巴胺和呋塞米治疗慢性顽固性心力衰竭合并中重度水肿的效果研究

Study on the effect of chronic refractory heart failure with edema by continuous intravenous infusion of dopamine and furosemide

目的评价持续静脉泵注多巴胺、呋塞米治疗慢性心力衰竭伴水肿的有效性和安全性。方法83例各种心脏疾病所致的慢性顽固性心力衰竭合并中重度水肿的患者,随机分为观察组(41例)与对照组(42例)。两组患者均以常规心力衰竭基础药物治疗,对照组予以常规强心利尿等方法,观察组予以多巴胺及呋塞米用恒速泵持续静脉泵入。比较两组患者心功能改善情况、水肿程度改善情况、水肿消退时间、住院时间及临床疗效。结果治疗后,观察组24 h平均尿量(2860.53±255.25)ml、水肿程度(0.53±0.35)度、N端脑钠肽前体(NT-proBNP)(1850.25±250.48)pg/ml、6 min步行距离(482.35±84.47)m及心功能分级(1.66±0.52)级,均优于对照组的(960.54±250.27)ml、(1.84±0.37)度、(3500.28±380.45)pg/ml、(362.33±60.45)m及(2.32±0.52)级,差异均具有统计学意义(P<0.05)。观察组总有效率97.56%、住院时间(6.11±3.21)d及显效时间(2.24±1.15)d均优于对照组的64.29%、(12.34±3.12)d、(9.43±2.11)d,差异均具有统计学意义(P<0.05)。结论持续静脉泵注多巴胺、呋塞米治疗慢性顽固性心力衰竭合并中重度水肿效果明显,值得临床广泛应用。

Objective To evaluate the efficacy and safety of continuous intravenous injection of dopamine and furosemide in the treatment of chronic heart failure with edema.Methods A total of 83 cases of chronic refractory heart failure with moderate to severe edema caused by various heart diseases were randomly divided into observation group(41 cases)and control group(42 cases).Both groups were treated with basic drugs of conventional heart failure,the control group was given conventional cardiopulmonary diuremia,and the observation group was given dopamine and furosemide by constant speed.The improvement of cardiac function,improvement of edema degree,time of edema resolution,hospitalization time and clinical efficacy were compared between the two groups.Results After treatment,the mean 24 h urine output(2860.53±255.25)ml and degree of edema(0.53±0.35)degree,N-terminal probrain natriuretic peptide(NT-proBNP)(1850.25±250.48)pg/ml,6 min walking distance(482.35±84.47)m and cardiac function grading(1.66±0.52)grades of the observation group were better than(960.54±250.27)ml,(1.84±0.37).degree,(3500.28±380.45)pg/ml,(362.33±60.45)m and(2.32±0.52)grades of the control group,and the difference was statistically significant(P<0.05).The total effective rate 97.56%,hospitalization time(6.11±3.21)d and effective time(2.24±1.15)d of the observation group were better than 64.29%,(12.34±3.12)d and(9.43±2.11)d of the control group,and the difference was statistically significant(P<0.05).Conclusion Continuous intravenous pump injection of dopamine and furosemide is effective in treating chronic refractory heart failure with moderate to severe edema,and it is worthy of clinical application.