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观察大剂量呋塞米持续静脉泵入治疗伴有利尿剂抵抗心力衰竭的临床疗效。方法:选取我院2010年1月至2015年8月心内科顽固性心衰患者32例,所有患者已合理给予洋地黄、血管转换酶抑制剂、硝酸酯类药物,纠正病因诱因,吸氧治疗无效、心功能Ⅲ-Ⅳ级的顽固性心衰患者,用微量泵持续泵入呋塞米,以10-40mg/h持续静脉泵入,保持每日尿量不少于1500ml,治疗前后分别评价心功能、胸片、心率、及6min步行试验。结果:大剂量呋塞米持续静脉泵入治疗伴有利尿剂抵抗心力衰竭可明显改善患者的症状,治疗后HR、心胸比率、LVS与治疗前比较均有显著下降(P<0.05),LVEF、6min步行试验与治疗前比较均有显著增加(P<0.05),因治疗时间较短,左室舒张末期内径(LVD)与治疗前比较无显著下降(P>0.05)。结论:大剂量呋塞米持续静脉泵入治疗可显著改善伴有利尿剂抵抗心力衰竭患者的症状,而且安全可靠。
To observe the clinical efficacy of high-dose furosemide sustained intravenous infusion in patients with congestive heart failure. Methods: Thirty-two patients with intractable heart failure in our department from January 2010 to August 2015 were enrolled in this study. All patients were given digitalis, angiotensin converting enzyme inhibitors and nitrates drugs reasonably to correct the etiology, oxygen therapy Invalid, cardiac function Ⅲ-Ⅳ grade refractory heart failure patients, continuous infusion of furosemide with a small pump to 10-40mg / h continuous intravenous infusion, to maintain daily urine output of not less than 1500ml, before and after treatment were evaluated Heart function, chest X-ray, heart rate, and 6min walking test. Results: Continuous bolus injection of furosemide with diuretics to resist heart failure could significantly improve the symptoms of the patients. After treatment, HR, cardiothoracic ratio, LVS were significantly decreased compared with those before treatment (P <0.05), LVEF, 6min walk test significantly increased compared with that before treatment (P <0.05). Because of the short duration of treatment, left ventricular end-diastolic diameter (LVD) did not significantly decrease compared with that before treatment (P> 0.05). CONCLUSION: Continuous bolus injection of high-dose furosemide can significantly improve the symptoms of diuretics in patients with heart failure and is safe and reliable.