摘要
目的观察胸段硬膜外阻滞(TEB)治疗重度心力衰竭(简称心衰,下同)的疗效。方法心功能Ⅲ、Ⅳ级患者82例,随机分为TEB联合药物治疗(T)组和单纯药物治疗(S)组,每组41例。T组每天从上午9时至晚上11时,每隔2小时硬膜外注射0.5%利多卡因4～5ml。两组均接受卡维地洛、强心、利尿、扩血管药物治疗。治疗前、后作心脏超声检查,测量心脏结构及左室收缩功能。结果两组疗程、卡维地洛用量无显著性差异。但T组呼吸困难消退时间、水肿消退时间和静脉用药时间均较S组缩短(P<0.05)。T组治疗后心脏各腔室内径缩小,左室重量指数降低,左室形态由球形向椭圆形转变(P<0.05),S组治疗后心脏结构无变化。T、S组治疗后心功能均有改善,尤以T组明显(P<0.05)。结论TEB治疗重度心衰疗效确切。
Objective To observe the efficacy of thoracic epidural block (TEB) in the treatment of patients with serious congestive heart failure. Methods Eighty-two patients with cardiac function class Ⅲ or Ⅳ were randomly divided into two groups, forty-one patients in TEB plus drug treatment group (T) and forty-one patients in single drug treatment group (S). Patients in group T were administrated epidurally 0.5% lidocaine 4-5ml every two hours from 9 a.m. to 11 p.m. everyday. Meanwhile, both groups were given drug treatment included carvedilol, digoxin, diuretics and vasodilators. Echocardiography was performed before and after treatment to examine cardiac structure and left ventricular systolic function. Results There was no difference in the period of treatment or dosage of carvedilol in two groups. The time course of dyspnoea or edema subsiding and drugs intravenous injection was significantly shorter in group T than in group S. In patients with serious heart failure, dimension of respective cardiac chamber was reduced, and left ventricular weight index was depressed, and left ventricular geometry was changed from sphericity to ellipse after treatment in group T (P<0.05), which were unchanged in group S. The improvement of cardiac function was significantly better in group T than in group S (P<0.05). Conclusion TEB treatment was efficient in patients with serious congestive heart failure.
出处
《临床麻醉学杂志》
CAS
CSCD
2005年第4期229-231,共3页
Journal of Clinical Anesthesiology
基金
黑龙江省"十五"科技攻关项目(编号:GB01C12603)
