大剂量呋塞米持续静脉泵入治疗老年重度心力衰竭患者的疗效分析

Therapeutic efficacy of continuous intravenous pumping of high-dose furosemide in elderly patients with severe heart failure

摘要:

目的 观察大剂量呋塞米持续静脉泵入对老年重度心力衰竭患者心功能的影响及疗效分析。方法 选取2018年3月—2020年5月青岛阜外心血管病医院收治的重度心力衰竭患者50例。采用随机数字表法将患者分为治疗组与对照组，各25例。对照组给予常规药物治疗，治疗组在对照组基础上首次给予呋塞米40 mg/h微量泵入治疗，再以10 mg/h的速度持续静脉泵入200 mg呋塞米，观察两组患者治疗后临床疗效、症状改善时间、心功能指标及不良反应发生情况。结果 治疗组临床总有效率高于对照组（P <0.05）。治疗组气促缓解时间、水肿消退时间短于对照组（P <0.05）。治疗组治疗前后左心室射血分数、心率、每搏心输出量及左心室舒张末期内径的差值大于对照组（P <0.05）。治疗组不良反应总发生率低于对照组（P <0.05）。结论 大剂量呋塞米持续静脉泵入治疗重度心力衰竭疗效显著，可有效促进患者临床症状的改善，有利于提高心功能，降低药物不良反应，值得临床推广并应用。

Abstract:

Objective To observe the effects of continuous intravenous pumping of high-dose furosemide on the heart function of elderly patients with severe heart failure and to analyze its therapeutic efficacy.Methods A total of 50 patients with severe heart failure admitted to Qingdao Fuwai Cardiovascular Hospital from March 2018 to May 2020 were included as the subjects. All patients were divided into treatment group and control group (25 cases in each group) by random number table method. The control group was given conventional drug treatment. The treatment group was initially given furosemide 40 mg per hour via syringe pump on the basis of the control group, and then 200 mg of furosemide was administrated via continuous intravenous pumping at a rate of 10 mg/h. We observed the therapeutic efficacy, time to symptom improvement, cardiac function and occurrence of adverse reactions in the two groups.Results After the treatment period, the overall response rate (92.00%) of the treatment group was significantly greater than that of the control group (68.00%) (P = 0.015, χ²= 4.500). The time to achieve remission of shortness of breath and that of edema in the treatment group were shorter than those of the control group (t = 4.935 and 5.970, respectively; both P < 0.05). The differences of left ventricular ejection fraction, heart rate, stroke volume and left ventricular end-diastolic dimension before and after the treatments were higher in the treatment group compared with the control group (P < 0.05). The overall incidence of adverse reactions in the treatment group during the treatment period (4.00%) was significantly lower than that of the control group (28.00%) (χ² = 5.357, P < 0.05).Conclusions Continuous intravenous pumping of high-dose furosemide exhibits significant therapeutic efficacy in severe heart failure. It can effectively improve clinical symptoms and cardiac function, and reduce adverse drug reactions. Thus, it is worthy of further clinical application.