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目的:观察左心房导管输注去甲肾上腺素联合多巴胺对心力衰竭合并重度肺动脉高压患者的抢救效果,探讨其临床适用性。方法:选择2014-03-2016-10于我院就诊的116例心力衰竭合并重度肺动脉高压患者,随机住院号法分为观察组58例和对照组58例,对照组给予多巴胺抢救,观察组联合左心房导管输注去甲肾上腺素治疗。观察2组患者的治疗效果,治疗前后心功能改善情况,肺动脉压治疗效果,治疗前后血BNP改善情况。结果:观察组与对照组的治疗有效率比较,差异有统计学意义(96.55%vs.84.48%,P<0.05);2组患者治疗前LVEF、LVDD、SV、CO及E/A比较,差异均无统计学意义,治疗后均改善(P<0.05),且观察组患者的各项心功能指标改善情况均明显优于对照组,差异有统计学意义(P<0.05)。2组患者治疗前肺动脉压及BNP比较,差异均无统计学意义,治疗后,肺动脉压和BNP均显著下降,差异有统计学意义(P<0.05),且观察组患者肺动脉压和BNP水平均显著低于对照组(P<0.05)。结论:左心房导管输注去甲肾上腺素联合多巴胺对心力衰竭合并重度肺动脉高压治疗效果更佳,在抢救过程中对心肺功能均有显著改善,适合临床长期推广应用。
Objective: To observe the effect of left atrial catheter infusion of norepinephrine combined with dopamine in patients with heart failure and severe pulmonary hypertension, and to investigate its clinical applicability. Methods: 116 patients with heart failure and severe pulmonary hypertension treated in our hospital from March 2014 to June 2016 were enrolled. Randomized hospitalization was divided into observation group (58 cases) and control group (58 cases). The control group was given dopamine rescue and the observation group was combined Left atrial catheter infusion of norepinephrine treatment. To observe the treatment effect of two groups of patients, before and after treatment to improve cardiac function, pulmonary arterial pressure treatment, improvement of blood BNP before and after treatment. Results: There was significant difference between the observation group and the control group (96.55% vs 84.48%, P <0.05). The difference of LVEF, LVDD, SV, CO and E / A before treatment in the two groups was statistically significant (P <0.05). The improvement of each cardiac function index in the observation group was better than that in the control group (P <0.05). The pulmonary arterial pressure and BNP in two groups before treatment had no statistical significance. After treatment, the pulmonary pressure and BNP were significantly decreased (P <0.05), and the pulmonary arterial pressure and BNP level in the observation group Significantly lower than the control group (P <0.05). Conclusion: Left atrial catheter infusion of norepinephrine combined with dopamine is more effective in treating heart failure complicated with severe pulmonary hypertension. It has a significant improvement in cardiopulmonary function during the rescue and is suitable for long-term clinical application.