主动脉内球囊反搏联合小剂量呋塞米治疗重症心脏瓣膜病患者术后并发低心排综合征效果分析.docVIP

主动脉内球囊反搏联合小剂量呋塞米治疗重症心脏瓣膜病患者术后并发低心排综合征的效果分析 　　[摘要]目的 观察主动脉内球囊反搏联合小剂量利尿药呋塞米持续微量泵入治疗重症心脏瓣膜病患者术后并发低心排综合征的临床疗效。方法 选取2006年11月～2015年12月东莞康华医院收治的82例重症心脏瓣膜病术后并发低心排综合征患者作为研究对象。将其随机分为单纯应用主动脉内球囊反搏治疗的对照组（40例）和应用主动脉内球囊反搏联合小剂量呋塞米持续泵入治疗的研究组（42例），观察比较两组患者治疗后低心排综合征改善情况、主动脉内球囊反搏辅助的时间，血管活性药多巴胺及肾上腺素的应用剂量，肾功能肌酐值的变化及心脏指数（CI）的变化情况。结果 两组患者治疗后低心排综合征均有不同程度改善，研究组低心排综合征的总有效率为90.5%，明显高于对照组的75.0%（P0.05）。与对照组比较，研究组的主动脉内球囊反搏辅助时间较短，多巴胺及肾上腺素的应用剂量较小，肌酐值的变化范围波动较小，CI升高明显，差异有统计学意义（P0.05）。对照组死亡率为25.0%，明显高于研究组的9.5%。结论 主动脉内球囊反搏联合小剂量呋塞米治疗重症心脏瓣膜病术后并发低心排综合征的效果明显，病死率较低，为心外科治疗此病提供重要参考依据。 　　[关键词]主动脉内球囊反搏；呋塞米；重症心脏瓣膜病；低心排综合征；心肌顿抑 　　[中图分类号] R654.2 [文献标识码] A [文章编号] 1674-4721（2016）07（a）-0040-04 　　[Abstract]Objective To observe the clinical effect of intra-aortic balloon counterpulsation combining with a small dosage of furosemide via sustained micro-pumping in the treatment of postoperative low cardiac output syndrome in patients with severe cardiac valve disease.Methods 81 patients with severe cardiac valve diseases who suffered from the complications of postoperative low cardiac output syndrome were admitted into our hospital from November 2006 to December 2015 and selected as research object.They were randomly divided into control group（n=40；only intra-aortic balloon counterpulsation） and research group（n=42；intra-aortic balloon counterpulsation combining with a small dosage of furosemide via sustained micro-pumping）.Improvement of low cardiac output syndrome after treatment，time of intra-aortic balloon counterpulsation，dosage of vasoactive drugs including dopamine and epinephrine，changes of creatinine value，and changes of cardiac index were observed and compared.Results After therapy，low cardiac output syndrome in the two groups was improved to a certain degree.In the research group，the total effective rate of low cardiac output syndrome was 90.5%，much higher than that in the control group accounting for 75.0%（P 　　[Key words]Intra-aortic balloon counterpulsation；Furosemide；Severe cardiac valve disease；Low ca