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| Clinical value of thoracic epidural block in treating heart failure of dilated cardiomyopathy |
| YU Zhongwei |
| Department of Medicine, Deqing Hospital of Huzhou city, Zhejiang Province, Huzhou 313201, China |
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Abstract Objective To investigate the clinical value of thoracic epidural blockade for heart failure with dilated cardiomyopathy. Methods From January 2015 to June 2017, 80 cases with heart failure with dilated cardiomyopathy in Deqing Hospital in Huzhou City were selected and divided into control group and observation group, each group with 40 cases. The control group was received routine medical conservative treatment, the observation group were underwent invasive thoracic epidural subjective intrathecal anesthesia and local anesthesia. All patients were observed during hospitalization. All participants were observed at the time point within the course of treatment as a starting point, 3 days after intervention the two group with stress related factors: plasma levels of epinephrine (E) and norepinephrine (NE) were compared. One month after intervention, the echocardiographic parameters of left ventricular diameter and left ventricular ejection fraction changes were compared, one day and one week after intervention, brain natriuretic peptide (BNP) trends were compared also. Results There was no significant difference in plasma E and NE levels between the two groups before intervention (P > 0.05). Three days after intervention, plasma E and NE levels in both groups were significantly lower than those before intervention (P < 0.05). After intervention, the levels of plasma E and NE in the observation group were significantly lower than control group (P < 0.05). Before the intervention, the left ventricular diameter and the left had no statistically significant difference (P > 0.05). After intervention, the left ventricular ejection fraction and left ventricular ejection fraction of echocardiography in observation group were better than before intervention, and the left ventricular diameter and left ventricular ejection fraction of echocardiography in observation group after intervention were better than control group after intervention, the differences were statistically significant (P < 0.05). There was no significant difference in BNP levels between the two groups before intervention (P > 0.05). The levels of BNP in the two groups were lower than those before the intervention, the levels of BNP in observation group were significantly lower than those in control group, the differences were statistically significant (P < 0.05). Conclusion For patients with dilated cardiomyopathy complicated with heart failure, the implementation of thoracic epidural block has important value in reducing stress response, delaying myocardial expansion, improving myocardial oxygen consumption and promoting heart failure recovery.
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