左西孟旦治疗围手术期老年髋部骨折合并心衰患者的疗效研究

目的探讨左西孟旦治疗围手术期老年髋部骨折合并心力衰竭患者的疗效。 方法回顾性分析2013年1月至2016年12月于邯郸市第一医院接受手术治疗且符合纳入标准的老年髋部骨折合并心力衰竭的患者64例（股骨颈骨折30例，股骨转子间骨折34例），根据围手术期是否使用左西孟旦，分为左西孟旦组和对照组，其中左西孟旦组32例，对照组32例，比较应用左西孟旦前、术后24 h、7 d后左室射血分数（LVEF）、心输出量（CO）、心脏指数（CI）、B型钠尿肽水平（BNP），对左西孟旦的疗效进行评价。 结果左西孟旦组术后24 h、术后7 d LVEF、CI、CO均明显高于同时间对照组（LVEF：t=2.428，t=3.150；CI：t=3.349，t=3.777；CO：t=2.615，t=2.620，均P<0.05），左西孟旦组术后24 h、术后7 d BNP水平明显低于对照组，差异有统计学意义（t=2.989，t=2.693，P<0.05）。 结论左西孟旦可改善老年髋部骨折合并心力衰竭患者围手术期的血流动力学指标，改善心脏功能及预后。

Effectivness study of Leosimendan in the treatment of perioperative in elderly hip fracture with heart failure

ObjectiveTo study the effect of levosimendan in the treatment of elderly heart failure patients underwent urgent hip fracture repairment. MethodsA retrospective analysis was performed in the First Hospital of Handan from January 2013 to December 2016, including 64 (30 femoral neck fracture, 34 intertrochanteric fracture) elderly hip fractures conforming to inclusion criteria. Patients were divided into levosimendan group and control group according to the application of levosimendan, the levosimendan group had 32 cases same as the control group. The left ventricular ejection fraction (LVEF), b-type natriuretic peptide (BNP) and cardiac output (CO), cardiac index (CI) before application of levosimendanat 24 h and 7 d after surgery were compared to evaluate the curative effect of levosimendan. ResultsLVEF, CO, CI at 24 h and 7 d after syrgery in Leosimendan group were significantly higher than control group (LVEF: t=2.428, t=3.150; CI: t=3.349, t=3.777; CO: t=2.615, t=2.620, P<0.05), BNP levels at 24 h and 7 d after surgery in leosimendan group was significantly lower than the control group, with statistical significance (t=2.989, t=2.693, P<0.05). ConclusionLevosimendan can be used to improve heart function and prognosis of elderly hip fracture with heart failure by regulating perioperative hemodynamic index.