摘要
目的探讨低钠血症对老年慢性心力衰竭的影响及有效的防治措施.方法回顾性分析曲靖市第一人民医院2006年1月至2011年6月60岁以上的慢性充血性心力衰竭住院患者126例,其中并发低钠血症者(低钠组)59例,正常血钠者(对照组)67例,比较两组病死率、心衰级别与血钠浓度的关系,同时对应用高渗盐水纠正低钠血症、改善心力衰竭的疗效进行分析.结果老年慢性心力衰竭低钠组病死率高于对照组(P<0.01);中重度心衰组血钠水平低于轻、中度心衰组(P<0.01);在行吸氧、强心、利尿、减轻心脏后负荷等常规治疗的同时给予高渗氯化钠注射液治疗,其心功能改善时间较不用高渗氯化钠治疗明显缩短.结论老年慢性心力衰竭级别越高,血钠浓度越低,其病死率越高,低钠血症与病死率有明显相关性;在对老年慢性心力衰竭病人治疗过程中应定期监测血钠浓度,合理使用利尿剂,以便及早发现和纠正低钠血症,提高慢性心力衰竭救治的成功率;应用高渗氯化钠注射液对迅速纠正低钠血症、改善心功能有明显效果.
Objective To explore the influence of hyponatremia on older chronic heart failure and effective prevention and control measures.Methods We retrospectively analysed 126 old congestive heart failure patients over 60 in our hospital from January 2006 to June 2011,including 59 patients with hyponatremia（hyponatremia group）and 67 patients with normal blood sodium（control group）.We compared the mortality,heart failure grade and the concentration of sodium blood between the two groups,and applied high permeability saline to correct hyponatremia and improve the curative effect of heart failure.Results The mortality of hyponatremia group was significantly higher than the control group（P0.01）.The blood sodium levels of patients in moderate and severe heart failure groups were lower than light and medium heart failure group（P0.01）.On the basis of conventional treatment including inhalating oxygen,giving cardiotonic,diuresis,and lessen the cardiac afterload,giving high-osmolar sodium chloride injection shortened the recover time of cardiac function.Conclusions For old chronic heart failure patients,the higher the level of heart failure and the lower the serum sodium level,the higher the mortality.Hyponatremia and mortality have a significant relationship.For the elderly patients with chronic heart failure in treatment process,we should regularly monitor the blood sodium concentration,reasonable use diuretics,so that early detection and correction hyponatremia,improve the success rate of chronic heart failure treatment.The high permeability sodium chloride injection can rapidly correct hyponatremia and significantly improve heart function.
出处
《昆明医学院学报》
2011年第9期96-98,共3页
Journal of Kunming Medical College
关键词
老年慢性心力衰竭
低钠血症
高渗氯化钠
Old people with chronic heart failure
Hyponatremia
High permeability sodium chloride
