心力衰竭专用超滤脱水装置治疗重症心力衰竭合并利尿剂抵抗患者的效果研究

Effect of special ultrafiltration dehydration device for heart failure in treatment of patients with severe heart failure complicated with diuretic resistance

  • 摘要:
    目的 观察心力衰竭专用超滤脱水装置对重症心力衰竭合并利尿剂抵抗患者的治疗效果。
    方法 选择重症心力衰竭合并利尿剂抵抗患者30例为研究对象。所有患者均根据有关指南先予以利尿剂、强心剂、扩血管等常规药物治疗,发生利尿剂抵抗后,再行心力衰竭专用超滤治疗。超滤期间不使用利尿剂,超滤结束后第24小时给予呋塞米针剂40 mg静脉推注。观察超滤治疗前后纽约心脏病协会心功能分级、呼吸困难评分、足踝周径、体质量、尿量、呼吸频率、心率、心输出量、左室射血分数、氨基端前B型钠尿肽(NT-proBNP)以及肾功能电解质等指标的变化。
    结果 经过心力衰竭专用超滤技术治疗,患者纽约心脏病协会心功能分级、呼吸困难评分以及下肢水肿方面的总有效率达100.0%。治疗后,患者体质量、呼吸频率、心率、肌酐(Cr)及NT-proBNP相较治疗前下降,心输出量、左室射血分数及尿量相较治疗前增加,差异均有统计学意义(P < 0.05)。患者治疗前后血钾、血钠比较,差异无统计学意义(P>0.05)。整个治疗过程中未发生死亡事件。
    结论 使用心力衰竭专用超滤脱水装置治疗重症心力衰竭合并利尿剂抵抗患者,可快速改善心功能,改善利尿剂抵抗,且治疗过程安全。

     

    Abstract:
    Objective To observe the effect of special ultrafiltration dehydration device for heart failure in the treatment of patients with severe heart failure complicated with diuretic resistance.
    Methods A total of 30 patients with severe heart failure and diuretic resistance were selected as research objects. All the patients were treated with diuretics, cardiotonics, vasodilators and other conventional drugs according to relevant guidelines, and they were treated with special ultrafiltration for heart failure after diuretic resistance. Diuretics were not used during ultrafiltration, and 40 mg furosemide injection was given intravenously at the 24th hour after ultrafiltration. The changes of cardiac function classification of New York Heart Association, dyspnea score, ankle circumference, body mass, urine volume, respiratory rate, heart rate, cardiac output, left ventricle ejection fraction, N-terminal pro-B-type natriuretic peptide (NT-proBNP) and renal function electrolyte were observed before and after ultrafiltration.
    Results After special ultrafiltration technology for heart failure, the total effective rate was 100.0% in the improvement of cardiac function classification of New York Heart Association, dyspnea score and lower limb edema. Body mass, respiratory rate, heart rate, creatinine (CR) and NT-proBNP of patients decreased significantly after treatment, cardiac output, ejection fraction and urine volume increased after treatment compared with treatment before (P < 0.05). There were no significant differences in blood potassium and blood sodium of patients before and after treatment (P>0.05). No death occurred during the whole treatment.
    Conclusion For patients with severe heart failure and diuretic resistance, special ultrafiltration dehydration device for heart failure can rapidly improve cardiac function and diuretic resistance, and the treatment process is safe.

     

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