两种方法治疗急性心肌梗死伴急性心力衰竭患者的疗效观察及护理  

Comparison of two different treatments and nursing on heart failure patients following acute myocardial infarction

作　　者：罗利霞[1] 黄丽萍[1] 王瑞芸[1] 

机构地区：[1]广州市红十字会医院心血管内科,广东广州510220

出　　处：《现代临床护理》2009年第7期49-51,14,共4页Modern Clinical Nursing

摘　　要：目的比较重组人脑利钠肽(rhBNP)和硝普钠(SNP)治疗急性心肌梗死伴急性心力衰竭患者的效果,并总结护理经验。方法将60例急性心肌梗死伴急性心力衰竭的患者随机分为rhBNP组和SNP组,每组各30例。用药期间严密监测血压,维持血压在90/60mmHg以上,共治疗72h。比较两组患者治疗前后血压、心率、尿量、呼吸困难改善情况、血肌酐和住院时间。结果rhBNP组患者的平均住院时间为(19.2±2.0)d,硝普钠组为(25.1±3.7)d,经统计学分析,P<0.05,差异具有统计学意义;两组患者用药后血压下降的幅度、心率减慢、尿量增加和呼吸困难改善情况比较,经统计学分析,均P<0.05,差异具有统计学意义。结论rhBNP治疗急性心肌梗死伴急性心力衰竭患者更加有效和安全。Objective To compare the effect of recombinant human brain natriuretie peptide （rhBNP） and sodium nitroprusside （SNP） on treating acute heart failure （AHF） patients following acute myocardial infarction （AMI）, and to summarize the nursing experience. Methods Sixty patients with AMI complicated with AHF were randomly divided into rhBNP and SNP group, and each group had 30 patients. The blood pressure was closely monitored and was maintained above 90/60 mmHg. The total duration of intravenous drug infusion in each group was 72 h. Blood pressure, heart rate, 24 h urine volume,the level of dyspnea, the level of serum creatinine and the mean duration of hospitalization were compared before and after the treatment. Results Compared with SNP group, rhBNP group had a greater heart rate reduction （P 〈 0.05）, higher 24 h urine volume （P 〈 0.05）, more significant alleviation in dyspnea （P 〈 0.05）, and greater reduction of the mean value of serum creatinine （P 〈 0.05）. The mean duration of hospitalization in the rhBNP was shorter than the nitropmsside group （P 〈 0.05）. The mean value of the systolic blood pressure or the diastolic blood pressure （P 〈 0.05） in the rhBNP group was higher than in the SNP group during the three days of treatment. The nursing of patients was similar in the two groups. Conclusion rhBNP is more effective and safer in treating AHF patients following AMI ccompared with SNP.

关 键 词：重组人脑利钠肽 硝普钠 心力衰竭 心肌梗死 护理 

分 类 号：R542.22[医药卫生—心血管疾病] R541.6[医药卫生—内科学] R473.5[医药卫生—临床医学]