慢性心力衰竭患者临床管理与评估

Management and Assessment in Patients with Chronic Heart Failure

尽管近年来在慢性心力衰竭(CHF)的治疗方面取得了较大的进展,但CHF患者仍有较高的住院率及病死率。CHF临床实践指南的发布促进了规范化治疗。为了取得良好的医疗效果,临床医生必须对心力衰竭患者提供一系列复杂的药物治疗及严格的自我控制措施。随着医学的不断发展,出现了包括心脏再同步化起搏、左心室辅助装置或心脏移植等治疗,而这些手段常需要在对患者进行危险性评估的基础上进行。严格遵循指南并使CHF患者出院后的教育与各种支持项目相结合才能够在一定程度上减低患者的再住院率及病死率。

Despite advances in the treatment of patients with chronic heart failure （HF）, these patients remain at high risk for hospitalization and death. To summarize the goals of heart failure care, clinical practice guidelines have been published by several organizations. Physicians treating patients with heart failure due to HF must prescribe a complex treatment plan involving multiple medications and rigorous self--care practices to achieve optimal care. Timing for the introduction of oth- er therapies, including resynchronization pacing, left ventricular assist devices, or cardiac transplantation, often is based on an assessment of patient risk. Optimal pharmacotherapy according to guideline and the effects of heart failure patient discharge education combined with various post--discharge support programs have demonstrated benefits with respect to reductions in hospitalizations and mortality.