重组人脑利钠肽在不同左室射血分数的急性心力衰竭患者中的应用与护理  

Application and Nursing Care of Recombinant Human Brain Natriuretic Peptide in Patients with Acute Heart Failure with Different Left Ventricular Ejection Fraction

作　　者：牛广红[1] 刘光艳[1] 李静[1] Niu Guanghong;Liu Guangyan;Li Jing(Qilu Hospital of Shandong University,Jinan Shandong 250012,China)

机构地区：[1]山东大学齐鲁医院,山东济南250012

出　　处：《齐鲁护理杂志》2019年第7期55-58,共4页Journal of Qilu Nursing

摘　　要：目的:探讨重组人脑利钠肽(rh BNP)在不同左室射血分数(LVEF)的急性心力衰竭(心衰)患者中的应用效果及护理对策。方法:选择急性心衰患者67例,根据LVEF分为三组:射血分数减低组(LVEF <40%,HFr EF)、射血分数中间值组(LVEF40%～49%,HFm EF),射血分数保留组(LVEF≥50%,HFp EF)。所有患者在应用托拉塞米基础上,给予rh BNP持续泵入5 d,观察应用rh BNP期间患者生命体征、利尿剂用量、脑钠肽(NT-proBNP)水平、肾功能及电解质变化,并实施临床护理干预措施。结果:三组患者对治疗反应均较好,NT-proBNP显著降低,托拉塞米用量减少,同时对肾功能及电解质无显著影响;心衰症状明显减轻,患者舒适度增加。结论:HFr EF患者在应用rh BNP过程需密切监测血压,必要时减量或联用升压药; HFm EF和HFp EF患者需密切监测尿量,避免利尿剂过量,造成血容量不足。采用临床护理措施干预后,能够明显降低药物不良反应,提高临床治疗效果和患者满意度。Objective:To investigate the application effect and nursing countermeasures of recombinant human brain natriuretic peptide(rhBNP)in patients with acute heart failure(HF)with different left ventricular ejection fraction(LVEF).Methods:A total of 67 patients with acute heart failure were selected and divided into three groups according to LVEF:the ejection fraction reduction group(LVEF<40%,HFrEF),the ejection fraction median group(LVEF 40%~49%,HFmEF),and the ejection fraction retention group(LVEF 50%,HFpEF).Based on the application of torasemide,all patients were given rhBNP continuous pumping for 5 days,and the patients′vital signs,diuretic dosage,brain natriuretic peptide(NT-proBNP)level,renal function and electrolyte changes during the application of rhBNP were observed,and clinical nursing intervention measures were implemented.Results:The three groups of patients have a good response to treatment,NT-proBNP significantly reduced,the amount of torasemide reduced,while has no significant impact on the renal function and electrolyte.The symptoms of heart failure were significantly reduced and the patients′comfort was increased.Conclusion:the blood pressure of HFrEF patients should be closely monitored during the rhBNP application,and the dosage should be reduced or combined with the booster drug if necessary;Patients with HFmEF and HFpEF should closely monitor urine volume to avoid excessive diuretics and insufficient blood volume.Clinical nursing intervention can significantly reduce adverse drug reactions,improve clinical treatment effect and patient satisfaction.

关 键 词：重组人脑利钠肽 射血分数 心力衰竭 护理 

分 类 号：R473.54[医药卫生—护理学]