非负荷量静脉补钠在慢性心衰并真性低钠血症中的应用  

Intravenous Drip of Non-Loading Dose Hypertonic Saline Solution in Patients with Hyponatremia and Chronic Heart Failure

作　　者：钟文[1] 任继刚[2] 阳运强 席新龙[1] 赵强[1] 

机构地区：[1]成都市彭州市人民医院心血管内科,四川成都611930 [2]成都市第六人民医院心内科,四川成都610051

出　　处：《现代临床医学》2016年第5期331-333,共3页Journal of Modern Clinical Medicine

摘　　要：目的:探讨采用非负荷量静脉补钠对低钠血症伴慢性心力衰竭患者的血钠水平、急性左心衰发生率及住院日的影响。方法:将2011年1月至2014年9月收治的60例中重度低钠血症伴慢性心力衰竭患者随机分为对照组与治疗组,各30例。2组均经静脉补充高渗氯化钠注射液,同时予以利尿与限制水摄入<1 000 m L/d,治疗时间共6 d。对照组采用负荷量静脉补钠法,治疗组采用非负荷量静脉补钠法。在试验前及试验的第3天、第5天、第7天各测1次空腹血钠水平,记录急性左心衰发作次数及住院日。结果:在治疗过程中,2组血钠水平及住院日无显著性差异(P>0.05),第7天治疗组的血钠水平与对照组是等效的(P<0.05),而治疗组急性左心衰发生率显著低于对照组(16.67%vs 40.00%,P<0.05)。结论:采用非负荷量静脉补钠治疗中重度低钠血症伴慢性心力衰竭患者可有效地纠正低钠血症,同时可预防急性左心衰发生。Objective：To explore the influence of non-loading dose hypertonic saline solution infusion on serum natrium level, the incidence of acute left heart failure and hospitalized days in patients with hyponatremia and moderate to severe chronic heart failure .Methods：From January 2011 to September 2014, 60 cases of of hyponatremia and moderate to severe chronic heart failure were randomly allocated into control group and treatment group, 20 cases in each group. The control group was intravenously administered with loading dose hypertonic saline solution while the treatment group did with non-loading dose one. All patients were given frusemide with intake water less than 1 000 mL/d.The treatment lasted for 6 days.Serum natrium was measured before treatment and on the 3rd, 5th and 7th day after treatment, respectively;the times of acute left heart failures and hospitalized days were recorded.Results：Serum natrium level and hospitalized days had no significant differences between the two groups（P〉0.05）;on the 7th day, the serum level of treatment group was equal to that of the control group（P〈0.05）,but the former showed significantly lower incidence of acute left heart failure than the control group （16.67%vs 40.00%, P〈0.05）. Conclusion：It is effective to treat hyponatremia with chronic heart failure by non-loading dose hypertonic saline solution infusion, which may prevent acute left heart failure.

关 键 词：低钠血症 高渗氯化钠 慢性心力衰竭 

分 类 号：R541.61[医药卫生—心血管疾病]