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本文报告以酚妥拉明及速尿联合治疗难治性心力衰竭25例的临床疗效。 1 临床资料 本组25例,男17例,女8例,年龄40～78岁,肺心病15例,风心病5例,高心病4例,扩张性心肌病1例。按NYHA标准评定,Ⅳ级19例,Ⅲ级6例。25例均为先后用过低盐饮食、洋地黄、利尿剂而心衰不能控制或恶化的顽固性心衰患者。 2 剂量及观察方法 全部病例均在治疗原发病、吸氧、低盐饮食治疗的基础上,均加酚妥拉明10～20mg于5％葡萄糖100ml中静滴,每日1次,速尿60～500mg/d,单次静脉注射最大剂量120mg,每4～8小时一次,直到出现尿钠排出治疗过程中常规给予氯化钾1～2g,全部病例均在治疗前后测定体重、血压、血清K~+、Na~+、C1~-、Ca~++、白蛋白量,肌酐、尿素氮值。 3 结果
This article reports the clinical efficacy of phentolamine and furosemide combined treatment of refractory heart failure in 25 cases. 1 Clinical data The group of 25 patients, 17 males and 8 females, aged 40 to 78 years, 15 cases of pulmonary heart disease, rheumatic heart disease in 5 cases, 4 cases of heart disease, dilated cardiomyopathy in 1 case. According to NYHA standards, 19 cases were grade Ⅳ and 6 cases were grade Ⅲ. Twenty-five patients were refractory heart failure patients who had used low-salt diet, digitalis, diuretic, and heart failure without control or worsening. 2 Dosage and observation methods All cases were in the treatment of primary disease, oxygen, low-salt diet based on the addition of phentolamine 10 ~ 20mg in 5% glucose 100ml intravenous infusion, once daily, furosemide 60 ~ 500mg / d, a single intravenous injection of the maximum dose of 120mg, once every 4 to 8 hours until the routine urinary sodium excretion of potassium chloride during the course of treatment 1 ~ 2g, all cases were measured before and after treatment body weight, blood pressure, serum K ~ +, Na ~ +, C1 ~ -, Ca ~ + +, albumin, creatinine, urea nitrogen value. 3 results