托拉塞米及多巴胺联合静脉滴注治疗顽固性心力衰竭的观察与护理

目的观察大剂量托拉塞米联合多巴胺治疗顽固性心力衰竭的临床疗效。方法选择顽固性心力衰竭患者53例，随机分成2组：联合治疗组27例，在常规治疗基础上给予大剂量托拉塞米联合多巴胺治疗；对照组26例，给予常规治疗，治疗5～7d。观察患者血压、心率、尿量、肾功能及电解质等改善情况。结果治疗后，联合治疗组患者心率、体重、血钾、BNP下降，尿量、血钠、6min步行距离增加，NYH分级改善，水钠潴留明显减轻，与对照组比较，差异有统计学意义（P〈0．05）。结论托拉塞米联合多巴胺治疗顽固性心力衰竭具有较好疗效。

Observation and nursing care of torasemide and dopamine intravenous in treatment of refractory heart failure

Objective To evaluate the effects of the combination of high- dose torasemide and dopamine in the treatment of refractory congestive heart failure （CHF）. Methods Fifty- three patients （20 females, 33 males） with refractory CHF were randomized into two groups. Combined therapy group received an intravenous infusion of torasemide plus dopamine twice daily. Control group received only with conventional treatment. The treatment was last 5--7 days. We evaluated if blood pressure, heart rate, urinary volume, electrolyte, renal function and so on were improved. Results In Combined therapy group, heart rate, bodyweight, potassium, BNP were reduced, uri- nary volume, sodium, six minute walk test（6MWT） were increased. NYHA class was improved and water - sodium retention was reduced. Compared with control group, the difference was signifi- cant （P 〈 0. 05 ）. Conclusion The combination treatment with high - dose torasemide and dopamine in refractory CHF has good effect.