改良利尿合剂持续泵入治疗难治性心力衰竭28例临床观察

目的观察改良利尿合剂治疗难治性心力衰竭的治疗效果。方法将2006年6月至2008年8月在我院急诊科和心内科住院的50例符合诊断的难治性心力衰竭的患者随机分为利尿合剂治疗组28例和常规治疗组22例。常规治疗组给予强心、利尿、扩血管等对症支持治疗,利尿合剂组在此基础上给予改良利尿合剂持续泵入。两组均7 d为1个疗程,连续观察治疗2个疗程后比较两组的总有效率、近期治愈率及心功能指标。结果治疗组在总有效率,临床近期治愈率及心功能指标改善方面,均明显优于对照组(P<0.05),而且伴随症状胸闷、喘促、水肿等积分改善情况,与对照组比较差异有统计学意义(P<0.05)。结论改良利尿合剂持续泵入对难治性心力衰竭的临床疗效明显优于常规治疗,且未见明显不良反应,值得临床推广。

The Effect of Continuous Modified Diuretic Mixture in 28 Patients with Refractory Heart Failure

Objective To evaluate the therapeutic potential of modified diuretic mixture in refractory heart failure. Methods 50 patients diagnosed as refractory heart failure admitted between June, 2006 and August, 2008 in our hospital were randomly assigned to experimental group （ n = 28 ） and control group （ n = 22 ）. Patients in control group received inotrope, diuretics, vasodilators, as well as other supportive treatment, while patients in experimental group received continuous intravenous modified diuretic mixture added to the routine therapy above. The effective rate, short-term recovery rate and the index of cardiac function were examined after 14 days （two courses of treatment）. Results Compared with control group, the experimental group achieved higher overall effective rate and short-term recovery rate,demonstrated a favorable improvement in cardiac function and obvious symptom reliefs （assessed by grades of chest discomfort, shortness of breath, as well as edema）after treatment （ P 〈 0. 05 ）. Conclusion This finding indicates that continuous intravenous modified diuretic mixture significantly overweighs the routine therapy in refractory heart failure, with no observed adverse effects, which deserves more clinical application.