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床旁超滤脱水装置治疗扩心病心力衰竭患者
2017-08-15 04:55:56 中国青年网
近日,太原市人民医院心血管内科收治了一名扩心病心力衰竭患者,该患者53岁,间断胸憋、气短、腹胀、浮肿、不能平卧3年之久。多家医院就诊治疗,症状缓解不明显。入院时患者全身浮肿、端坐呼吸,血压低,病情危重,积极予以药物抗心衰治疗,仍觉腹胀不适,浮肿缓解不明显。
该科主任刘亮接诊此患者后,经过查体、完善相关检查,带领全科医务人员针对病情进行充分讨论,诊断患者为扩张型心肌病,慢性心衰急性发作,长期进食少,营养不良,合并低蛋白血症、电解质紊乱,因此利尿脱水是关键。但由于患者长期应用利尿剂,首先疗效会大打折扣,其次会加重电解质紊乱。最终,刘亮决定应用该科新引进的床旁超滤脱水机为患者进行脱水利尿,减轻心衰症状。
在医护人员的严密监护下,经过20多个小时超滤脱水治疗,脱水3000余毫升,患者现可以平卧,腹胀、心悸、浮肿症状消失,心衰指标明显好转。
太原市人民医院是市属医院中首家引进床旁超滤脱水装置的医院,该设备帮助患者经外周静脉建立体外循环,体外血流速度慢,采用单纯等渗超滤脱水,不需要透析液及置换液,使用过程不影响电解质及酸碱平衡,血压影响小。其具有的独到优势,是临床心衰治疗的又一把利剑。
本报记者 李永江
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