摘要
目的制订暴发性心肌炎患者容量管理方案并评价其实施效果。方法成立容量管理小组,基于相关指南及文献制订暴发性心肌炎患者容量管理方案。采用便利抽样法,对2019年3月—12月武汉市某三级甲等医院收治的19例暴发性心肌炎患者实施容量管理,收集患者一般资料及治疗结局,比较其入院时和出院时心肌肌钙蛋白I、B型脑钠肽前体、左心室射血分数以及生活自理能力等指标。结果1例患者因多器官衰竭而死亡,18例患者治愈出院,治愈率为94.74%;与入院时相比,患者心肌肌钙蛋白I均由>50000 pg/ml下降至<100 pg/ml,B型脑钠肽前体均由>4000 pg/ml下降至<500 pg/ml;左心室射血分数从(25.17±6.77)%上升至(51.50±3.87)%,差异具有统计学意义(P<0.001);患者生活自理能力评分从(11.11±2.74)分上升至(82.78±4.92)分,差异具有统计学意义(P<0.001)。结论暴发性心肌炎患者容量管理方案有助于改善患者治疗结局及心功能,提高其生活自理能力。
Objective To formulate fluid management plan for patients with fulminant myocarditis and evaluate the effects.Methods We set up a fluid management group and developed the fluid management plan for patients with fulminant myocarditis based on the relevant guidelines and literature.By convenient sampling,it was carried out for 19 patients with fulminant myocarditis who visited a tertiary class A hospital in Wuhan from March to December 2019.The general data and outcome of the treatment was collected.The cardiac troponin I,pro-B-type natriuretic peptide,left ventricular ejection fraction and self-care ability were compared at admission and discharge.Results One patient died of multiple organs failure.18 patients were cured.The survival rate was 94.74%.Compared with that at admission,the cardiac troponin I was depressed from more than 50000 pg/ml to less than 100 pg/ml.The pro-B-type natriuretic peptide was depressed from more than 4000 pg/ml to less than 500 pg/ml.The left ventricular ejection fraction increased from(25.17±6.77)%to(51.50±3.87)%.The differences were statistically significant(P<0.001).The self-care ability scores increased from(11.11±2.74)to(82.78±4.92)with statistically difference(P<0.001).Conclusion Fluid management of fulminant myocarditis patients can improve the treatment outcome and cardiac function status,improve the quality of life.
作者
陆丽娟
张帆
管志敏
王昭昭
汪晖
何细飞
LU Lijuan;ZHANG Fan;GUAN Zhimin;WANG Zhaozhao;WANG Hui;HE Xifei
出处
《中华急危重症护理杂志》
2021年第2期127-131,共5页
Chinese Journal of Emergency and Critical Care Nursing
基金
华中科技大学同济医学院附属同济医院科研基金资助项目(2019D02)
关键词
心肌炎
容量管理
急症护理
Myocarditis
Fluid Management
Emergency Nursing
