CAJ | 학술논문

目的：观察3%氯化钠注射液静脉滴注治疗慢性心力衰竭（CHF）合并低钠血症的疗效。方法选取2010年6月~2014年6月解放军266医院收治的CHF伴低钠血症患者108例，其中男性66例，女性42例，在常规吸氧、利尿、强心等治疗基础上，给予静脉滴注3%氯化钠，滴速10~15 ml/h，每天补充3%氯化钠50~200 ml，使血钠浓度至正常低限（135 mmol/L）。观察入院2周内患者治疗前后左室射血分数（LVEF）、每搏量（SV）、左室收缩末内径（LVSD）、左室舒张末内径（LVDD）、血钠浓度及临床疗效等。结果与治疗前比较，治疗后LVEF（33±7）%vs.（51±8）%明显增加；SV（45±6） ml vs.（71±6）ml明显增加，差异具有显著统计学意义（P＜0.01）。与治疗前比较，治疗后LVSD（46±7）mmvs.（40±7）mm下降；LVDD（61±9）mmvs.（50±10）mm下降，差异具有统计学意义（P＜0.05）。与治疗前比较，治疗后血钠浓度升高，差异具有统计学意义（P＜0.05）。经过治疗显效67例，有效35例，无效6例，其中死亡3例，总有效率94.5%。结论静脉补充3%氯化钠，能及时纠正心力衰竭患者的低钠血症，改善心功能、提高心力衰竭的疗效。
목적：관찰3%록화납주사액정맥적주치료만성심력쇠갈（CHF）합병저납혈증적료효。방법선취2010년6월~2014년6월해방군266의원수치적CHF반저납혈증환자108례，기중남성66례，녀성42례，재상규흡양、이뇨、강심등치료기출상，급여정맥적주3%록화납，적속10~15 ml/h，매천보충3%록화납50~200 ml，사혈납농도지정상저한（135 mmol/L）。관찰입원2주내환자치료전후좌실사혈분수（LVEF）、매박량（SV）、좌실수축말내경（LVSD）、좌실서장말내경（LVDD）、혈납농도급림상료효등。결과여치료전비교，치료후LVEF（33±7）%vs.（51±8）%명현증가；SV（45±6） ml vs.（71±6）ml명현증가，차이구유현저통계학의의（P＜0.01）。여치료전비교，치료후LVSD（46±7）mmvs.（40±7）mm하강；LVDD（61±9）mmvs.（50±10）mm하강，차이구유통계학의의（P＜0.05）。여치료전비교，치료후혈납농도승고，차이구유통계학의의（P＜0.05）。경과치료현효67례，유효35례，무효6례，기중사망3례，총유효솔94.5%。결론정맥보충3%록화납，능급시규정심력쇠갈환자적저납혈증，개선심공능、제고심력쇠갈적료효。
Objective To observe the curative effect of intravenous drip of 3% sodium chloride injection on chronic heart failure (CHF) accompanied by hyponatremia.Methods The patients with CHF accompanied by hyponatremia (n=108, male 66 and female 42) were chosen from Jun. 2010 to Jun. 2014. After given routine treatment (including oxygen uptake, dieresis, reducing cardiac afterload and strengthening heart), all patients were given intravenous drip of 3% sodium chloride injection (10 mL/h-15 mL/h and from 50 mL to 200 mL a day) until reaching lower limit of normal of serum sodium level (135 mmol/L). The changes of LVEF, SV, VSD, LVDD, serum sodium level and clinical efficacy were observed in all patients within 2 w after hospitalization.Results After treatment, LVEF [(33±7)%vs. (51±8)%] and SV [(45±6) mLvs. (71±6) mL] increased significantly (P<0.01), and LVSD [(46±7) mmvs. (40±7) mm] and LVDD [(61±9) mmvs. (50±10) mm] decreased (P<0.05). The serum sodium level increased after treatment (P<0.05). Among all patients, there were 67 with significant efficacy, 35 with curative effect, 6 without efficacy and 3 died, and the total effective rate was 94.5%.Conclusion The intravenous drip of 3% sodium chloride injection can correct hyponatremia, improve heart function and increase curative effect in patients with CHF.