高龄老年重症急性心力衰竭的救治  

Treatment for severe acute heart failure in oldest old patients

作　　者：郑秋甫[1] 段留法[2] 张丽萍[2] 

机构地区：[1]解放军总医院专家组,北京100853 [2]解放军总医院南楼心血管二科,北京100853

出　　处：《解放军保健医学杂志》2008年第2期87-89,共3页Journal Of Health Care And Medicine in Chinese Pla

摘　　要：目的总结高龄老年重症急性心力衰竭的治疗经验。方法19例平均年龄85.46±5.14岁的高龄老年重症急性左心衰患者,应用利尿剂,血管扩张剂、吗啡、气管插管人工机械辅助呼吸、主动脉内球囊反搏(IABP)及双心室起搏等治疗措施。结果2例高血压、2例慢性肾衰尿毒症、1例肺部感染、2例陈旧性心肌梗死、2例急性心肌梗死、1例扩张性心肌病患者,经上述药物治疗后重症急性左心衰完全缓解;8例患者因1型呼衰而行气管插管,人工机械辅助呼吸;1例急性心肌梗死因低血压难以纠正行IABP,1例扩张性心肌病因反复心力衰竭行双心室起搏治疗。1例手术后重症急性心力衰竭治疗无效死亡。该19例中,18例存活,1例死亡。结论本组以利尿剂,血管扩张剂、吗啡为主治疗高龄老年重症急性心力衰竭的疗效较好。Objective To sum up the effect of treatment on severe acute heart failure in oldest old patients. Methods Nineteen patients （mean 85.46±5.14 years old）with severe acute heart failure were retrospectively analysed. Treatment with diuretic, vasodilator, morphine, artificial ventilation, intra-aortic balloon pump, dual-chamber pacing for severe acute heart failure were used. Results Ten patients with severe acute heart failure that included 2 cases with hypertension,2 cases with chronic renal failure, lease with pulmonary infection,2 cases with old myocardial infarction,2 cases with acute myocardial infarction,1 case with dilated cardiomyopathy,were controled by medication. 8 patients were used artificial ventilation therapy ,one patient with acute myocardial infarction association with shock was used intra-aortic balloon pump therapy, one patient with dilated cardiomyopathy was used dual- chamber pacing therapy. Of 19 patients, 18 patients were survived and 1 patient was dead. Conclusions Treatment with diuretic, vasodilator, morphine for severe acute heart failure is optimal.

关 键 词：急性心力衰竭 治疗 高龄老年 

分 类 号：R541.6[医药卫生—心血管疾病]