80岁以上老年人多病因心力衰竭诊治中的几个问题

Diagnosis and treatment of multifactor heart failure in the patients aged over 80 years

目的对老年人多病因心力衰竭中的出血、贫血、退行性心脏瓣膜病、慢性肾功能不全等问题的诊治做探讨。方法本文收集1998-2004年住广州军区广州总医院80岁以上老年人多病因心衰病例145例,就其资料完整的127例的病因构成与组合进行回顾。结果老年心力衰竭患者往往因为有多种病因存在,增加了临床上诊断和处理的难度。结论对老年人多病因心衰进行治疗时,须多学科协作,调控各系统间的相互影响,抓住主要矛盾,重点治疗其原发病及去除诱因。根据老年特点,格外注意选择药物及调控药物,做到细致和稳妥,注意个体不同耐受性,避免发生副作用。

Objective To investigate the problems of bleeding,anemia,degenerative heart valve diseases and chronic renal failure in the diagnosis and treatment of multifactor heart failure in the elderly. Methods A total of 145 cases of multifactor heart failure in old patients aged over 80 years admitted to this hospital between 1998-2004 were reviewed retrospectively, and 127 of them with complete clinical data were analyzed. Results Heart failure in the elderly was usually caused by many medical conditions,increasing the difficulty of its diagnosis and management. Conclusions Multi-discipline approach is needed in the management of heart failure with multiple etiological factors in the elderly,with the emphasis on the treatment of primary condition and the inducing factors, taking into consideration of interaction between different body systems, carefully choosing the treatment regimen and closely monitoring the pharmacodynamics and pharmacokinetics of various drugs ,with special attention to possible adverse reactions