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目的:观察呋塞米治疗产后妊娠期高血压疾病性心衰患者疗效。方法:将120例产后妊娠期高血压性心衰患者随机分为呋塞米治疗组(治疗组1、治疗组2、治疗组3)和常规治疗组(对照组)。观察4组患者在不同呋塞米用量下西地兰用量、硝酸甘油用量、心衰缓解时间。结果:治疗组3呋塞米常规用量平均是232 mg,尿蛋白≥+++时平均用量586 mg,西地兰平均用量0.8 mg、硝酸甘油平均用量78 mg,较其他3组皆明显减少(P<0.01);心衰平均缓解时间30 h,与其他3组比较差异有统计学意义(P<0.01)。血清钾、钠维持正常范围。结论:产后妊娠期高血压性心衰在西地兰、硝酸甘油、氨茶碱、吗啡、地塞米松的基础上静注大量呋塞米,快速减低心脏前负荷,能够较快地控制心衰,减少西地兰、硝酸甘油的用量,血清钾、钠维持正常范围,是一种安全、可靠的治疗产后妊娠期高血压性心衰理想药物之一。
Objective: To observe the efficacy of furosemide in the treatment of postpartum hypertensive patients with heart failure. Methods: 120 patients with postpartum hypertensive heart failure during pregnancy were randomly divided into furosemide treatment group (treatment group 1, treatment group 2, treatment group 3) and conventional treatment group (control group). The dosage of cedilanid, the amount of nitroglycerin and the time of heart failure were observed in 4 groups of patients under different dosage of furosemide. Results: In the treatment group, the average dosage of furosemide 3 was 232 mg, the average amount of urinary albumin ≥ +++ was 586 mg, the average dose of cedilanid 0.8 mg and the average amount of nitroglycerin 78 mg were significantly lower than the other three groups P <0.01). The mean heart failure response time was 30 h, which was significantly different from the other three groups (P <0.01). Serum potassium and sodium maintain the normal range. CONCLUSIONS: Postpartum hypertensive heart failure during pregnancy induced a large amount of furosemide on the basis of cedilanid, nitroglycerin, aminophylline, morphine and dexamethasone, rapidly reducing the pre-cardiac load and controlling heart failure rapidly , Reduce the amount of cedilanid and nitroglycerin, and maintain the normal range of serum potassium and sodium. It is a safe and reliable drug for the treatment of postpartum pregnancy-induced hypertensive heart failure.