高位硬脊膜外腔阻滞治疗难治性心力衰竭疗效观察

目的:观察高位硬脊膜外腔阻滞(TEA)治疗难治性心力衰竭的治疗效果及不良反应。方法:取胸椎4~5间隙为穿刺点,每6~8h推注0.25%罗哌卡因注射液5~7ml,共用4周,监测血压、心率、心电图、心胸比、左室舒张末期内径、左室射血分数、不良反应等。结果:TEA治疗难治性心力衰竭10例,总有效率90%,治疗后心率、血压均较前明显下降,心功能较前明显改善,心律失常明显减少,差异均有统计学意义(均P<0.05)。结论:TEA治疗难治性心力衰竭安全、有效,其远期疗效有待于进一步观察。

Effect of thoracic epidual analgesia to treat obstinate heart failure

Objective:Ropivacaine was used for thoracic epidual analgesia(TEA), to treat obstinate heart failure by coronary heart disease,and the therapeutic effects and side effects were observed. Method: A total of 10 patients were injected 0.25% ropivacaine (5~7 ml per six to eight hours) for four weeks. Observing blood pressure, heart rate ,cardiac enzymes and electrocardiograms, the ratio of heart size to chest size, the left ventricular end-diastolic diameter, ejection fraction and side effect et. Result:Ten patients obstinate heart failure by coronary heart disease were treated by TEA,the successful hemostasis rate was 90%. After treatment ,heart rate and blood pressure obviously decreased ,cardiac function significantly increased,cardiac arrhythmia obviously reduced (P<0.05). Conclusion:It is safe and effective to use ropivacaine to treat obstinate heart failure by coronary heart disease.Following up study should be paid in order to ascertain the long-term effect.