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本文小结65例难洽性心衰病例,在祛除基本病因和并发症同时,合并使用小剂量的扩血管药和多巴胺,其显效及有效率达85.5％。本文提出在没有条件监测心输出量和左室舒张未压或肺毛楔压的情况下,可参考床边资料选药。如有肺部罗音、紫绀、肺水肿时宜选用减轻前负荷为主的药物(如硝酸盐制剂),而表现为紫绀、皮肤湿冷、脉压差小时,则选用减轻后负荷为主的药物(如卞胺唑啉、肼苯哒嗪及敏乐啶等);硝普纳、哌唑嗪及血管增压素转换酶抑制剂为均等降低前、后负荷的药物。
This article summary 65 cases of difficult heart failure cases, in the elimination of the basic causes and complications, combined with the use of small doses of vasodilators and dopamine, the effective and effective rate of 85.5%. This paper suggests that in the absence of conditions to monitor cardiac output and left ventricular diastolic pressure or pulmonary wedge pressure circumstances, refer to the bedside selection of drugs. If pulmonary rales, cyanosis, pulmonary edema should be used to reduce the pre-load-based drugs (such as nitrate preparations), which showed cyanosis, skin wet cold, pulse pressure difference is small, then choose to reduce the load-based drugs Such as Bianamizoline, hydralazine and sensitive music such as pyridine); nitroprusside, prazosin and vasopressin-converting enzyme inhibitors for equal reduction before and after the load of drugs.