The Importance Of Hemodialysis For The Treatment Of Rheumatic Valvular With Refractory Heart Failure

Objective: The problem of rhermatic ralvular with refractory heart failure is still intractability in the nowdays iatrology.Rhermatic ralvular with refractory heart failure have the same peculiarity as follows:The first,states of the illness are at stake and the death rate of this disease is very high. The second, the illness have refractory low tier syndrome and dropsy. The third, the disease in this stage have no react to the antidiuretic. The treatment of dilatation of blood vessels raises orthostatic hypotension and fall senseless easily .At the same time, drugs have toxicosis easily.The fourth,hydrolyte disorders.In the actual states, the treatments of hemodialysis and hemofiltration makes a mighty advance in the patients of refractory heart failure. The study is to look for an effective method in those patients having refractory heart failure.Methods: we studied two groups of patients: group 1 consisted of 18 patients(7 male, 11 female) who beceme refractory heart failure and received hemodialysis. These patients had hemodialysis alternis diebus and had 3 times total. Group 2 consisted of 20 patients(11 male, 9 female) who received medical therapy. All patients were New York Heart Association(NYHA) class 4.Kalemia, natremia,chloremia,BU,Cr, adrenine, arterenol, albumin, aldosterone, angiotensin2 and renin were observed before and after treatment in both groups. We analysis the comparability of the patient's conditions, medicine'effetivety of patients in group two,effectivety of hemodialysis in group one and draw a comparison in the two groups.Results: We anlyzed the clinical dates and drew a conclusion. The first, the indexs were ameliorated dppreciably in those patients who used hemodialysis(p<0.01). The second,Only the indexs of natrium and rennin were improred in those patients who used medical therapy(p<0.05). There was a lack of change in the part indexs(p>0.05).The three,The death rate in the group2 was hyper than the death rate in group 1. The fourth,the indexs have a hyper amelioraty in groupl than in group2(p<0.05). Patients with severe congestive heart failure become refractory to conventional medical therapy, leading to recurrent rehospitalizations. Hemodynamics and endocrine index in patients with refractory heart failure can be changed through hemodialysis. At the same time, we foundthat the regulation of the electrolytic equilibrium becomes impossible in patients with severe heart failure resistant to strong doses of diuretics in the oligo-anuric phase.Conclusion: Having a short-term hemodialysis in rhermatic ralvalar with refractory heart failure which have no effective to medicine can get a good effect. It can ameliorate the patient's symptom,reduce the burthen of the patient's heart,better the heart's function and load the active substance in the hema.Hemodialysis have the two functions of cure and "trigger". It can be used in clinic.Our study suggests that hemodialysis is a safe,feasible therapy and has the potential for offering another important therapeutic option for patients with severe heart failure. In a word, hemodialysis is very effective in treating refractory heart failure and better than medical therapy only.Writed by :gaomei Directed byrwangxu...