托拉塞米与呋塞米对心脏瓣膜病患者瓣膜置换术后心脏功能的影响  

The effects of tolasemide and furosemide on postoperative cardiac function in patients with valvular heart disease undergoing valve replacement surgery

作　　者：杨冬梅[1] 周鑫 孙黄涛[1] 邱志宏 游贯淼 Yang Dongmei;Zhou Xin;Sun Huangtao;Qiu Zhihong;You Guanmiao(Jiangxi Provincial People’s Hospital,Nanchang,Jiangxi 330033,China)

机构地区：[1]江西省人民医院,江西南昌330033

出　　处：《首都食品与医药》2024年第24期63-65,共3页Capital Food Medicine

摘　　要：目的观察托拉塞米与呋塞米对心脏瓣膜病患者瓣膜置换术后心脏功能的影响。方法按照随机数字表法将江西省人民医院2023年3月-2024年3月期间收治的78例心脏瓣膜病患者分为A组(39例)、B组(39例)。两组患者均实施瓣膜置换术治疗,术后A组给予托拉塞米治疗,B组给予呋塞米治疗,连续治疗7d。比较两组临床疗效、心功能指标[左心室射血分数(LVEF)、心排血量(CO)、心排血指数(CI)]、尿量、尿钠、尿钾水平及不良反应情况。结果A组治疗总有效率略高于B组,但组间比较,未见显著差异(P>0.05);两组治疗后LVEF、CO、CI均提高,且A组较B组高(P<0.05);两组给药12h、48-72h尿量、尿钠、尿钾均高于给药4h,且A组给药4h、12h、48-72h后尿量较B组高,尿钠、尿钾水平较B组低(P<0.05);两组治疗期间未出现严重不良反应。结论托拉塞米与呋塞米在心脏瓣膜病患者瓣膜置换术后应用均具有良好的辅助效果,但与呋塞米相比,托拉塞米利尿作用更为显著,可更好地调节患者术后机体内环境,利于心功能的恢复。Objective To observe the effects of tolasemide and furosemide on postoperative cardiac function in patients with valvular heart disease undergoing valve replacement surgery.Methods According to the random number table method,78 heart patients admitted to Jiangxi Provincial People’s Hospital from March 2023 to March 2024 were divided into Group A(39 patients)and Group B(39 patients).Both groups of patients underwent valve replacement surgery.After the surgery,Group A was treated with Torasemide,while Group B was treated with Furosemide for 7 consecutive days.Compare the clinical efficacy,cardiac function indicators[left ventricular ejection fraction(LVEF),cardiac output(CO),cardiac output index(CI)],urine output,urinary sodium,urinary potassium levels,and adverse reactions between two groups.Results The total effective rate of treatment in Group A was slightly higher than that in Group B,but there was no significant difference between groups(P>0.05);after treatment,LVEF,CO,and CI increased in both groups,and Group A was higher than Group B(P<0.05);the urine output,urine sodium,and urine potassium levels in both groups after 12 hours,48-72 hours of administration were higher than those after 4 hours of administration.In addition,after 4 hours,12 hours,and 48-72 hours of administration,the urine output in Group A was higher than that in Group B,while the levels of urine sodium and urine potassium were lower than those in Group B(P<0.05);no serious adverse reactions occurred during the treatment of both groups.Conclusion Both Torasemide and Furosemide have good adjuvant effects in patients with heart valve replacement surgery.However,compared with furosemide,torasemide has a more significant diuretic effect,which can better regulate the postoperative internal environment of patients and facilitate the recovery of heart function.

关 键 词：心脏瓣膜病 瓣膜置换术 托拉塞米 呋塞米 心脏功能 

分 类 号：R542.5[医药卫生—心血管疾病]