瓣膜置换术后持续静脉微量注射呋塞米疗效观察

目的：观察对比瓣膜置换术后患者持续静脉微量注射呋塞米或间断注射呋塞米的疗效,及呋塞米剂量和对血脑钠肽浓度的影响。方法：126例瓣膜置换患者随机分为观察组与对照组,观察组63例持续微量注射呋塞米,对照组63例间断注射呋塞米。根据常规术后处理,保持合理尿量和血液动力学指标水平,比较两组患者平均每日呋塞米总剂量,记录术后4,12 h尿量,测定两组术前和术后第3天血脑钠肽浓度。结果：观察组呋塞米日剂量低于对照组（P〈0.05）;两组均未发生严重不良反应（P〉0.05）;两组术前术后血脑钠肽浓度差异无统计学意义（P〉0.05）;观察组术后4,12 h尿量均明显高于对照组（P〈0.05）,两组术后24 h尿量差异无统计学意义（P〉0.05）。结论：瓣膜置换术后患者持续静脉微量注射呋塞米可减少呋塞米用量,利尿效果优于间断注射呋塞米,且不影响血脑钠肽浓度,无严重并发症。

Observation of the Effect of Microinfusion Pump of Furosemide on Postoperative Valve Replacement Patients

Objective：To investigate the effect of microinfusion pump of furosemide on postoperative valve replacement patients. Methods： 126 postoperative valve replacement patients were randomly assigned into treatment group （63 cases） and control group （63 cases） . The patients in the treatment group were continually microinfused with furosemide, while those in the control group were intermittenly infused with furosemide. The dosage of furosemide and the level of plasma of pro-LPBN were observed. Results： The dosage of furosemide was lower everyday in the treatment group （ P 〈 0.05 ）. The two groups had no serious adverse reactions such as deafness （ P 〉 0.05 ） ; their preoperative and postoperative plasma brain natriuretic peptide concentration had no significant difference （ P 〉 0.05） ; the 4h, 12h urine volumes of the patients in the observation group were significantly higher than those in the control group （ all P 〈 0.05 ）, the 24h urine volume had no significant difference of two group （ P 〉 0.05 ）. Conclusion ： Patients with persistent intravenous microinjeetion of furosemide in the treatment of valvular replacement could reduce their dose of furosemide. The treatment did not influence plasma brain natriuretic peptide concentration and had few serious complications, and its diuretic effect was better than that of the intermittent injection of furosemide.