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临床资料 严重心力衰竭44例,其中男24例,女20例。年龄23～84岁,平均52.2岁。急性左心衰竭16例,其中高心病4例,冠心病12例;慢性充血性心力衰竭28例,其中冠心病2例,风心病12例,扩张型心肌病10例,慢性肺心病4例。高血压者13例,非高血压者31例。毛地黄中毒4例,严重心律失常者12例。 用药方法 将硝普钠50mg溶于5％葡萄糖溶液500ml中静脉滴注,从小剂量(20μg/min)开始,逐渐增量,每5～10min增加10μg/min,严密监测血压,调整滴速至有效滴速维持之,持续滴注6～8h左右,每天给药1次。急性心力衰竭有效滴速范围39～162.5μg/min,平均78.8μg/min;平均用量193.75mg,最大用量350mg。用药天数2～7天,平均3.87天。慢性心力衰竭,有效滴速范围32.5～97.5μg/min,平均62.2μg/min,平均用量300mg,最大用量1600mg。用药天数1～32天,平均6天。用药后心衰完全纠正或明显好转者为显效,心衰好转者为有效,心衰无改善或恶化者为无效。 治疗结果 用药后全组病例皆有不同程度的血压下降,心率减慢,尤以高血压、急性左心衰竭者为著,但
44 cases of severe heart failure clinical data, including 24 males and 20 females. Age 23 to 84 years old, average 52.2 years old. There were 16 cases of acute left heart failure, including 4 cases of high heart disease, 12 cases of coronary heart disease, 28 cases of chronic congestive heart failure, including 2 cases of coronary heart disease, 12 cases of rheumatic heart disease, 10 cases of dilated cardiomyopathy and 4 cases of chronic pulmonary heart disease. Hypertension in 13 cases, non-hypertension in 31 cases. Foxglove poisoning in 4 cases, 12 cases of severe arrhythmia. Medication Methods Sodium nitroprusside 50mg dissolved in 500ml of 5% glucose solution intravenous infusion, starting from a small dose (20μg / min), gradually increased, every 5 ~ 10min increase 10μg / min, close monitoring of blood pressure, adjust the drip rate to effective Drip speed maintenance, continued infusion of about 6 ~ 8h, administered 1 day. The effective drip rate of acute heart failure ranged from 39 to 162.5μg / min with an average of 78.8μg / min; the average dosage was 193.75mg and the maximum dosage was 350mg. Medication days 2 to 7 days, an average of 3.87 days. Chronic heart failure, effective drip rate range 32.5 ~ 97.5μg / min, an average of 62.2μg / min, the average dosage of 300mg, the maximum dosage of 1600mg. Medication days 1 to 32 days, an average of 6 days. After treatment, heart failure completely corrected or significantly improved were markedly effective, heart failure improved for effective, no improvement or worsening of heart failure were ineffective. Treatment results All patients after treatment with varying degrees of blood pressure decreased heart rate, especially in patients with hypertension, acute left heart failure for, but