老年人心力衰竭的治疗

Treatment of Senile Heart Failure

本文对我院收治的100例,年龄60—82岁充血性心力衰竭患者的心脏病种类、诱因、临床和治疗特点进行了分析。临床特点以神经系统功能障碍为突出。老年人心衰利尿治疗应从小剂量开始、缓慢、间断给药。地高辛0.125—0.25mg/日,中毒率达22.64%,且随年龄而增加。83例使用血管扩张剂以减轻心脏前后负荷。对难治性心衰不宜用洋地黄类药物者,应用了非洋地黄正性肌力药物多巴胺或多巴酚丁胺治疗,当心衰合并低血压者,二药可同时联合使用。

In this paper,100 cases of congestive heart failure,aged from 60 to 82 years,have been summarized and analysed for clinical typing,predisposing causes,clinicaland therapeutic characteristics.The main clinical symptoms of them were dysfunctions of the nervous system.Diuretic therapy for old patients must be begun from small doses and proceededintermittently.Then the doses of the diuretics could be increased gradually.The into-xication rate was 22.64% and(?)increased with the age of the patient on digoxin 0.125-0.25 mg daily.Of 100 cases,83 patients have taken vasodilators to decrease the preload andafter load of the heart.Patients with refractory heart failure should not be givendigitalis.Howerer,positive inotropic drugs such as dopamine or dobutamine could begiven.For patients suffering from heart failure with hypotensin,dopamine ordobutamine used simutaneously might be helpful.