患有心力衰竭的患者的液体限制:系统性审查
Job J Herrmann1,2, Rachna van Berlo3, Hans-Peter Brunner-La Rocca4,5
1Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands Job.herrmann@radboudumc.nl.
Heart (British Cardiac Society)
|January 13, 2026
概括
心力衰竭 (HF) 管理中的液体限制没有显示出对死亡率或住院治疗的明显好处. 然而,它可能会增加口渴困扰,质疑其在HF患者的常规使用.
科学领域:
- 心脏病学 心脏病学
- 临床医学 临床医学
- 基于证据的实践.
背景情况:
- 液体限制是一种常见的,但研究不足的,非药物治疗心力衰竭 (HF).
- 有限的随机临床试验 (RCT) 数据需要对其有效性和安全性进行重新评估.
研究的目的:
- 系统地审查现有的随机临床试验 (RCT) 关于心力衰竭 (HF) 患者的流体限制.
- 评估流体限制的有效性和安全性,与不受限制或不那么严格的流体摄入相比.
主要方法:
- 搜索主要数据库 (CINAHL,EMBASE,PubMed,Cochrane图书馆) 到2025年5月为相关的RCT.
- 包括涉及成人HF患者的RCT,随机分配给液体限制与其他液体摄入策略.
- 专注于结果,包括死亡率,HF住院,生活质量 (QoL),口渴,NYHA类和NT-proBNP.
主要成果:
- 包括4个RCT和682名患者;只有一个具有偏差的低风险.
- 在死亡率或心力衰竭 (HF) 住院治疗中没有发现显著差异.
- 液体限制没有改善生活质量 (QoL),并且与增加口渴困扰有关.
结论:
- 目前关于心力衰竭 (HF) 流体限制的证据有限,并且往往存在高偏差风险.
- 对于死亡率或HF住院没有明显的好处,但有可能增加口渴.
- 常规的流体限制没有得到HF管理的当前证据的支持.
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