摘要
目的:观察联合使用高渗盐水和小剂量多巴胺对顽固性心衰合并低钠血症的疗效。方法:观察住院治疗的顽固性心衰患者60例,全部存在低钠血症。在常规治疗的基础上,随机将患者分为两组,两组的一般状况、每日尿量、血钠、血钾、血清肌酐水平无统计学差异。对照组30例常规强心利尿扩血管治疗纠正同时低钠血症,治疗组在对照组基础上加用小剂量多巴胺3～5μg/(kg.分)静脉泵入运用高渗盐水(3%),纠正低钠血症,两组都给予补钾补镁补钙治疗,比较两组治疗后总尿量、血钠、血钾以及血浆肌酐的变化及比较两组心功能分级变化(NY-HA)以及患者自觉症状的变化。结果:治疗后治疗组3天尿总量明显高于对照组4340±177m l vs 2650±118m l(P<0.05),患者心功能明显好转(X2=13.01,P<0.05)。两组血清钠均升高,但差异无显著性(P>0.05),两组血钾、血清肌酐水平无明显差异(P>0.05)。结论:联合使用高渗盐水和小剂量多巴胺治疗顽固性心衰合并低钠血症的患者可以取得较常规治疗更好的临床疗效。
Objective：To evaluate the clinic outcome of combination of dopaine hyperosmotic NaCl in the treatment of the Chronic congestive heart failure（CHF） combined hyponatremia.Methods：60 patients of CHF combined hyponatremia were divide into treatment group and control group randomly.The control group was treated with hyperosmotic NaCl based on regular treatment,The treatment group was treated with Dobaine additionally.The treatment was last 3 days.Compari-sion was done between the two groups,as the evaluation of improvement of clinical signs of patient,improvement of heart function,the voulume of urine of three days﹑the leval of Na＋ K＋ and Cr in the serum.Results：The total urine voulume of three days,total of significant utility rate in treatment group were significantly higher than those in control group after treatment（P0.05）hypertonic saline in two groups was corrected however the leval of Na＋ K＋ and Cr in the serum between two group were no significantly difference（P0.05）.Conclusion：Combination of dopaine hyperosmotic NaCl in the treatment of the Chronic congestive heart failure（CHF） combined hyponatremia was a effective methods.
关键词
心力衰竭
充血性
低钠血症
heart failure congestive hyponatremia
