不同管理模式对心衰患者利尿剂抵抗发生率及治疗耗时的影响研究  

Effect of Different Management Modes on the Incidence of Diuretic Resistance and the Time Required to Treat It in Patients with Heart Failure

作　　者：朱彬[1] 袁小蓉 Zhu Bin;Yuan Xiaorong(Department of Cardiovascular Medicine,Luzhou Hospital of Traditional Chinese Medicine,Luzhou 646000,China)

机构地区：[1]四川省泸州市中医医院心血管内科,泸州646000

出　　处：《成都医学院学报》2023年第2期187-190,共4页Journal of Chengdu Medical College

基　　金：西南医科大学-泸州市中医医院基地项目(No:2018-LH016)。

摘　　要：目的 探讨预防为主的利尿剂抵抗管理模式对中重度心衰患者利尿剂抵抗发生率及治疗利尿剂抵抗所需耗时的影响。方法 选取2020年8月至2022年2月在四川省泸州市中医医院心血管内科住院治疗的300例中重度心衰患者,入选对象1年内至少住院治疗两次,且3个月<两次住院间隔时间<6个月,均分型为“湿冷”或“湿暖”,入院时按美国纽约心脏病学会心功能分级为Ⅲ级或Ⅳ级。采用交叉设计、完全随机分组的方法,将患者分为AB组和BA组。AB组第1次住院实施利尿剂抵抗病因预防及“早发现、早诊断、早治疗”(以下简称“三早”)预防管理,第2次住院实施利尿剂抵抗常规管理;BA组两次住院实施方案与AB组相反。同步观察两组患者两次住院期间的利尿剂抵抗发生率和治疗利尿剂抵抗所需耗时。结果 相对于实施利尿剂抵抗常规管理阶段,两组患者在利尿剂抵抗病因预防及“三早”预防管理阶段的利尿剂抵抗发生率更低,治疗利尿剂抵抗所需耗时更短,差异有统计学意义(P<0.05)。结论 对于分型为“湿冷”或“湿暖”的中重度心衰患者,住院期间实施利尿剂抵抗病因预防及“三早”预防管理,能明显降低利尿剂抵抗发生率,缩短治疗利尿剂抵抗所需耗时。Objective To explore the effect of prevention oriented diuretic resistance management mode on the incidence of diuretic resistance and the time required to treat diuretic resistance in patients with moderate to severe heart failure.Methods A total of 300 patients with moderate to severe heart failure who were hospitalized in the cardiovascular department of Luzhou Hospital of Traditional Chinese Medicine in Sichuan Province from August 2020 to February 2022 were selected.The selected subjects were hospitalized at least twice within one year,and the interval between the two hospitalizations was more than 3 months and less than 6 months.And on admission,they were classified as"wet cold"or"wet warm",with a New York Heart Association(NYHA)cardiac function rating of GradeⅢor GradeⅣ.They were randomly divided into AB group and BA group by cross-over design.In group AB,"prevention of diuretic resistance etiology and three-early prevention management(early detection,early diagnosis and early treatment)"was implemented in the first hospitalization,and"routine management of diuretic resistance"in the second hospitalization.However,the sequence of management programs implemented in the two hospitalizations of group BA was reversed from that of group AB.The incidence of diuretic resistance and the time required to treat diuretic resistance in each hospitalization of the two groups were observed and analyzed.Results In both groups,the incidence of diuretic resistance was lower and the time required to treat diuretic resistance was shorter during the implementation of"prevention of diuretic resistance etiology and threeearly prevention management"than those during the implementation of"routine management of diuretic resistance",and the differences were statistically significant(P<0.05).Conclusion For patients with moderate to severe heart failure who are classified as"wet cold"or"wet warm",the implementation of"prevention of diuretic resistance etiology and three-early prevention management"during hospitalization can signi

关 键 词：病因预防 利尿剂抵抗发生率 治疗利尿剂抵抗所需耗时 中重度心衰 

分 类 号：R541.61[医药卫生—心血管疾病]