呋塞米治疗产后妊娠期高血压性心衰疗效观察

目的:观察呋塞米治疗产后妊娠期高血压疾病性心衰患者疗效。方法:将120例产后妊娠期高血压性心衰患者随机分为呋塞米治疗组(治疗组1、治疗组2、治疗组3)和常规治疗组(对照组)。观察4组患者在不同呋塞米用量下西地兰用量、硝酸甘油用量、心衰缓解时间。结果:治疗组3呋塞米常规用量平均是232 mg,尿蛋白≥+++时平均用量586 mg,西地兰平均用量0.8 mg、硝酸甘油平均用量78 mg,较其他3组皆明显减少(P<0.01);心衰平均缓解时间30 h,与其他3组比较差异有统计学意义(P<0.01)。血清钾、钠维持正常范围。结论:产后妊娠期高血压性心衰在西地兰、硝酸甘油、氨茶碱、吗啡、地塞米松的基础上静注大量呋塞米,快速减低心脏前负荷,能够较快地控制心衰,减少西地兰、硝酸甘油的用量,血清钾、钠维持正常范围,是一种安全、可靠的治疗产后妊娠期高血压性心衰理想药物之一。

Observation on the curative effect of furosemide in treatment of postpartum hypertensive disorder complicating pregnancy induced heart failure

Objective:To observe the curative effect of furosemide in treatment of postpartum hypertensive disorder complicating pregnancy(HDCP) induced heart failure. Methods:120 patients with postpartum HDCP induced heart failure were divided into furosemide groups(treatment group 1,treatment group 2 and treatment group 3) and conventional treatment group(control group) randomly.The dose of cedilanid,dose of nitroglycerin and remission time of heart failure in the four groups with different doses of furosemide were observed. Results:In treatment group 3,the mean conventional dose of furosemide was 232 mg,the mean dose was 586 mg when urine protein≥+++,the mean dose of cedilanid was 0.8 mg,the mean dose of nitroglycerin was 78 mg,all the doses above-mentioned were significantly lower than those in the other three groups(P<0.01);the mean remission time of heart failure in treatment group 3 was 30 hours,compared with the other three groups,there was significant difference(P<0.01).The levels of potassium and sodium in serum were within normal ranges. Conclusion:The patients with postpartum HDCP induced heart failure are treated with intravenous injection of large dose furosemide on the base of cedilanid,nitroglycerin,aminophylline,morphine and dexamethasone,the method can reduce cardiac preload rapidly,control heart failure quickly,reduce the doses of cedilanid and nitroglycerin,maintain the levels of serum potassium and sodium within normal ranges;furosemide is a safe,reliable and ideal drug in treatment of postpartum HDCP induced heart failure.