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目的 观察胸段硬膜外阻滞(thoracic Epidural analgesia,TEA)治疗慢性充血性心力衰竭(CHF)的临床疗效及安全性。方法 60例CHF患者随机分为胸段硬膜外阻滞组(治疗组)和常规治疗组(对照组)各30例,常规治疗组使用洋地黄、利尿剂、血管紧张素转换酶抑制剂、硝酸酯类、硝普钠等药物,治疗组在常规治疗的基础上,加用上胸段硬膜外阻滞治疗,疗程4周,每周测血压、心率,评定心功能,治疗前后检查超声心动图,记录不良反应。结果 治疗组心功能分级明显升高,左室射血分数(LVEF)、左室舒张末期内径(LVEDd)和左室收缩末期内径(LVESd)明显降低,各项与对照组比较差异有显著性(P<0.05)。结论 TEA治疗慢性充血性心力衰竭能改善心功能,改善左室重塑,且安全。
Objective To observe the clinical efficacy and safety of thoracic epidural analgesia (TEA) in the treatment of chronic congestive heart failure (CHF). Methods Sixty CHF patients were randomly divided into thoracic epidural block (treatment group) and conventional treatment group (control group), 30 cases each. The conventional treatment group received digitalis, diuretic, angiotensin converting enzyme inhibitor, Nitrates, sodium nitroprusside and other drugs, the treatment group on the basis of conventional treatment, plus the use of thoracic epidural block treatment for 4 weeks, weekly measurement of blood pressure, heart rate, heart function assessment, before and after treatment ultrasound Cardiogram, record adverse reactions. Results Compared with the control group, the scores of cardiac function in the treatment group were significantly increased. The left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDd) and left ventricular end-systolic diameter (LVESd) P <0.05). Conclusions TEA can improve cardiac function, improve left ventricular remodeling, and be safe in the treatment of chronic congestive heart failure.