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目的:观察对高容量负荷心衰合并低血压状态、肾功衰竭患者在药物治疗效果不理想、无效时给予主动脉球囊反搏(IABP)、连续性静脉-静脉血液滤过(CVVH)等多器官支持的治疗效果。方法:收集2008年到2015年60例临床确诊的高容量负荷心衰合并低血压状态、肾功能衰竭患者,根据是否联合应用IABP分为对照组和联合组,其中对照组34例,联合组26例。观察两组患者治疗前后血压、心率、肺部啰音、水肿程度及肾功能指标。结果:两组患者治疗后血流动力学参数、脑钠肽等均有改善,且联合组较对照组的各项参数有明显优势,差异均有统计学意义(P<0.05)。结论:IABP联合CVVH能够有效缓解药物治疗效果差或者无效的合并低血压状态、肾功能不全的高容量负荷心衰,提高抢救成功率,是安全、有效、积极的非药物治疗心衰的临床方法。
OBJECTIVE: To observe the effect of aortic insufflation (IABP), continuous veno-venous hemofiltration (CVVH), etc. on patients with high-volume load failure and hypotension, Multi-organ-supported therapeutic effect. Methods: Sixty clinically diagnosed patients with high-volume-load heart failure complicated with hypotension and renal failure from 2008 to 2015 were divided into control group and combination group according to whether they were combined with IABP. Among them, 34 patients in control group and 26 example. Before and after treatment, blood pressure, heart rate, pulmonary rales, edema and renal function indexes were observed. Results: The hemodynamic parameters, brain natriuretic peptide and so on were improved in both groups after treatment. The parameters in the combined group were significantly superior to those in the control group (P <0.05). Conclusion: IABP combined with CVVH can effectively alleviate the poor therapeutic effect or ineffective high volume load heart failure with hypotension and renal insufficiency and improve the success rate of rescue, which is a safe, effective and active non-drug clinical treatment of heart failure .