摘要
目的观察静脉给予托拉塞米对风湿性心脏病瓣膜置换术后患者在ICU中的临床疗效。方法以60例使用呋塞米利尿的患者为对照,观察52例风湿性心脏病瓣膜置换术后第3天的患者静脉给予首剂托拉塞米注射液后药物作用时间、血液电解质的变化;同时保持每天入量,静脉补钾、钠量相当,记录不同时段尿量,并测定尿液中钾、钠量。观察患者的症状、心率、呼吸、心电图和血流动力学变化及不良反应。结果两组患者在ICU治疗中均未出现恶心等消化道不良反应,给药前后血压、呼吸、心率、心电图和血流动力学均未出现显著改变。托拉塞米首剂静脉给药较呋塞米首剂给药作用时间明显延长(P<0.01)。当首剂给药后、尿量达到500 mL时,托拉塞米组血液电解质波动范围明显较小(P<0.01,P<0.05)。给药后0～4 h托拉塞米组尿量高于呋塞米组,尿钾、钠低于呋塞米组(P<0.05);0～12 h托拉塞米组尿量明显高于呋塞米组,尿钾、钠显著低于呋塞米组(P<0.01);0～24 h、48～72 h两组比较差异无统计学意义。结论对于风心病瓣膜置换术后早期在ICU中的患者,托拉塞米利尿作用及对机体内环境的稳定性明显优于呋塞米。
Objective To evaluate the clinical effect of torasemide on the rheumatic heart disease patients ＇after cardiac valve replacement in ICU. Methods 60 patients with intravenous injection of furosemide were in control group. Drug action time, blood electrolytic fluctuation, vital sign and hemodynamics of 52 rheumatic heart disease patients after cardiac valve replacement in ICU were observed. At the same time, venous transfusion, potassium and natrium equivalency in two groups, urine volume, potassium and natrium in urine were also observed. Results There was no significant difference in vital sign and hemodynamics between two groups. When urine volume was 500 mL, there was obviously significant difference in two groups of the first intravenous injection, the action time of torasemide was longer （ P 〈 0.01 ） and blood electrolytic fluctuation was lower （P 〈 0. 01, P 〈 0.05 ）. Urine volume was higher, potassium and natrinm in urine were lower in the torasemide group than in furosemide group at 0 - 4 h （ P 〈 0. 05 ） and at 0 -12 h（ P 〈0. 01 ） , specially at 0- 12 h. There was no significant difference at 0 -24 h and 48 -72 h. Conclusion Torasemide is superior to furosemide in diuretic effect and organism internal environmen stability for rheumatic heart disease patients after cardiac valve replacement in ICU.
出处
《中国急救医学》
CAS
CSCD
北大核心
2007年第11期987-989,共3页
Chinese Journal of Critical Care Medicine
关键词
托拉塞米
呋塞米
利尿作用
Torasemide
Furosemide
Diuretic effect
