微量泵注射硝酸异山梨酯治疗难治性心力衰竭疗效观察

Effect of isosorbide dinitrate by micro intravenous infusion pump on refractory heart failure

目的评价微量泵注射硝酸异山梨酯治疗难治性心力衰竭的疗效及安全性。方法选取2014年4月至2015年7月新河县人民医院心内科收治的难治性心衰患者126例,按随机数表法将患者分为对照组62例和观察组64例。对照组患者给予常规治疗,采用普通输液法输注硝酸异山梨酯注射液以扩张血管。观察组在对照组治疗的基础上改用微量泵注射硝酸异山梨酯治疗。两组均连续治疗3周。比较两组患者的症状和体征、调节输液所需的时间;心脏彩色多普勒检查两组患者心功能情况,以射血分数为主;采用纽约心脏病协会分级评价心功能情况;观察两组患者输液方法的安全性。结果观察组患者的治疗总有效率为96.9%,明显高于对照组的85.6%,差异有统计学意义(P<0.05);两组患者治疗前的射血分数(EF)比较,差异无统计学意义(P<0.05);治疗后,两组患者的EF均较治疗前明显提高,且观察组患者EF明显高于对照组,差异均有统计学意义(P<0.05);观察组患者水肿消退时间为(7.8±3.1)d,明显少于对照组的(10.2±1.4)d,呼吸困难改善所需时间为(10.6±3.3)d,亦明显少于对照组的(12.1±2.8)d,差异均有统计学意义(P<0.05);观察组患者平均每天调节输液所需时间仅为(4.7±0.9)min,明显少于对照组的(19.5±5.1)min,差异有统计学意义(P<0.05);观察组患者输液过程中出现不良反应2例,而对照组为9例,差异有统计学意义(P<0.05)。结论微量泵输注硝酸异山梨酯能够治疗难治性心力衰竭,其不仅能够有效改善患者的临床表现,还能高效可控地提高患者的心功能。

Objective To investigate the clinical effect and safety of isosorbide dinitrate by micro intravenous infusion pump on refractory heart failure(RHF). Methods A total of 126 patients with RHF, who admitted to Department of Internal Medicine of People's Hospital of Xinhe County during April 2014 to July 2015, were divided into the control group(n=62) and the observation group(n=64) according to random number table. The patients in control group were treated with conventional medication and isosorbide dinitrate injection by conventional infusion method to dilate blood. However, based on the control group's treatment, the patients in observation group received to isosorbide dinitrate injection with micro intravenous infusion pump. After 3 weeks of continuous treatment, the symptoms, signs and time of adjusted intravenous infusion were observed and compared between the two groups. The cardiac function was checked by echocardiography, mainly ejection fraction, which was evaluated by the New York Heart Association Scale(NYHA).The safeties of the infusion methods in both groups were observed. Results The total effective rate of the observation group was 96.9%, which was significantly higher than 85.6% in the control group(P<0.05). There was no statistically significant difference between the two groups in the ejection fraction(EF) before treatment(P>0.05). After treatment,the EF of the two groups were significantly higher than those before treatment, and the EF of the observation group was significantly higher than that of the control group(P<0.05). The edema subsided time and time of dyspnea improvement in the abservation group were respectively(7.8±3.1) d and(10.6±3.3) d, which was significantly less than(10.2±1.4) d and(12.1±2.8) d in the control group(P<0.05). In addition, the average time needed to adjust the intravenous infusion in the observation group was only(4.7±0.9) min, which was significantly less than(19.5±5.1) min in the control group(P<0.05). There were 2 cases of side-effect in the observation group and 9 cases in the control group, and the difference was statistically significant(P<0.05). Conclusion Micro-pump infusion of isosorbide dinitrate can effectively treat refractory heart failure, which not only can effectively improve the clinical manifestations of patients, but also was efficient and controllable to improve the patient's cardiac function.