老年重症心力衰竭急诊内科治疗的临床分析  

Emergency medical treatment of elderly patients with severe heart failure: a clinical analysis

作　　者：叶锦山[1] YE Jin-shan(Xiamen Hospital of Traditional Chinese Medicine,Xiamen 361009,China)

机构地区：[1]厦门市中医院,福建厦门361009

出　　处：《心血管病防治知识（学术版）》2018年第4Z期41-43,共3页Prevention and Treatment of Cardiovascular Disease

摘　　要：目的探讨老年重症心力衰竭急诊内科治疗方法及效果。方法研究对象均来自于我院急诊科的老年重症心力衰竭患者,入院治疗时间在2016年1月至2017年7月期间,共入选106患者,按国际随机数字表法分成两个研究组,即观察组和对照组,每组53例患者。两组患者入院后给予常规重症心力衰竭内科治疗,观察组额外给予美托洛尔和厄贝沙坦氢氯噻嗪进行治疗。结果观察组患者的临床治疗总有效率为92.45%(49/53),显著高于对照组的75.47%(40/53),P<0.05组间比较差异存在显著性。两组患者相比,治疗前的LVEF、LVEDVI、LVSAVI和E/A值等超声心动图指标均在同一水平,P>0.05组间比较差异不存在显著性;治疗后观察组患者的以上各项指标均明显优于对照,P<0.05组间比较差异存在显著性。观察组患者的心功能分级情况,明显优于对照组,P<0.05组间比较差异存在显著性。观察组患者随访期间复发率为7.55%(4/53),显著低于对照组的30.19%(16/53);死亡率为1.8%(1/53),显著低于对照组的15.09%(15/53);P<0.05组间比较差异存在显著性。结论对于老年重症心力衰竭患者在常规内科治疗基础上,联合给予美托洛尔和厄贝沙坦氢氯噻嗪可获得更加显著的疗效,不仅能提升临床疗效,同时能够有效改善患者的心功能,并降低患者的复发率和死亡率。Objective To investigate the emergency medical treatment methods for elderly patients with severe heart failure and their clinical effects.Methods A total of 106 elderly patients with severe heart failure who were admitted to Emergency Department in our hospital from January 2016 to July 2017 were enrolled and divided into observation group and control group using a random number table,with 53 patients in each group.Both groups were given the conventional medical treatment of severe heart failure,and the patients in the observation group were given metoprolol combined with irbesartan and hydrochlorothiazide in addition to the conventional medical treatment.ResultsThe observation group had a significantly higher overall response rate than the control group[92.45%(49/53)vs 75.47%(40/53),P<0.05].Before treatment,the two groups had similar echocardiographic parameters including left ventricular ejection fraction,left ventricular end-diastolic volume index,LVSAVI,and E/A ratio(P>0.05),while after treatment,the observation group had significantly better parameters than the control group(P<0.05).The observation group had a significantly better cardiac functional grading than the control group(P<0.05).Compared with the control group,the observation group had significantly lower recurrence rate[7.55%(4/53)vs 30.19%(16/53),P<0.05]and mortality rate[1.8%(1/53)vs 15.09%(15/53),P<0.05]during follow-up.Conclusion In elderly patients with severe heart failure,metoprolol combined with irbesartan and hydrochlorothiazide in addition to the conventional medical treatment can significantly improve patients'clinical outcome and cardiac function and reduce recurrence rate and mortality rate.

关 键 词：老年重症心力衰竭 急诊 内科治疗 

分 类 号：R541.6[医药卫生—心血管疾病]