急性失代偿性心力衰竭患者用药不良反应监测及护理对策研究

Acute decompensated heart failure patients with medication monitoring and nursing countermeasures of adverse reactions

目的：研究治疗急性失代偿性心力衰竭的常用药物、常见的不良反应及护理对策,为临床研究提供参考。方法：选择2011年3月-2014年5月来我院治疗的200例急性失代偿性心力衰竭患者,回顾性分析其临床资料,记录患者使用的治疗药物种类、发生的不良反应,记录全方位的护理措施。结果：通过调查,治疗急性失代偿性心力衰竭的药物分为五大类：重组B型利钠肽、钙增敏剂、血管紧张素受体拮抗剂、内皮素受体拮抗剂与他汀类药物。其中,使用重组人脑利钠肽治疗的136例,占68.0%;55.0%的急性失代偿性心力衰竭患者服用奈西利肽治疗;130例使用左西孟坦治疗;使用的其他药物还有多巴酚丁胺、盐酸考尼伐坦、依那普利以及阿托伐他汀等他汀类药物。急性失代偿性心力衰竭患者用药的不良反应有多种：134例出现低血压,占67.0%;148例患者出现低血钾的现象,占74.0%;112例出现窦性心动过速,占56.0%;106例出现心律失常,占53.0%;110例出现头痛,占55.0%;89例出现胃肠道不适,占44.5%;其他的不良反应还包括阵发性心房纤颤、频发室性期前收缩、心悸、肝肾功能损害等。针对急性失代偿性心力衰竭患者,全方位的护理措施包括4个方面：基础护理、健康知识宣传、心理护理与用药细则和护理,保障急性失代偿性心力衰竭患者的顺利恢复。结论：治疗急性失代偿性心力衰竭的药物有多种,需根据个体差异选择合适的药物。治疗该疾病的常见不良反应主要为低血压、低血钾、窦性心动过速、头痛、胃肠道不适等,严重影响了患者的身心健康。护理人员需进行全方位护理干预,保障患者的顺利恢复,提高治愈率。

Objective：To explore the analysis of acute decompensated heart failure commonly used drugs, common adverse reactions and nursing strategies, provide a reference for clinical research. Methods： to our hospital 200 patients with acute decompensated heart failure patients, a retrospective analysis of March 2011-2014 in May during clinical data of patients, the type of patient records using drugs, adverse reactions occur, record a full range of care measures. Results： Through the investigation, the drug treatment of acute decompensated heart failure is divided into five categories： recombinant B-type natriuretic peptide, a calcium sensitizer, vasopressin receptor antagonists, endothelin receptor antagonists and statins drugs. In which case the use of recombinant human brain sodium natriuretic peptide treated 136 cases, the proportion of 68.0%.55.0% of acute decompensated heart failure patients taking 奈西利peptide treatment of disease. 130 cases of patients using the left Simendan treatment of acute decompensated heart failure. There are other drugs dobutamine use conivaptan hydrochloride, enalapril and atorvastatin and other statins; adverse reactions in patients with acute decompensated heart failure medication variety： 134 cases patients with low blood pressure, the proportion of 67.0%, 148 cases of patients with hypokalemia phenomenon, the proportion of 74.0%, 112 patients developed symptoms of sinus tachycardia, the proportion of 56.0%of 106 patients experienced adverse symptoms of arrhythmia, 53.0%, 110 patients with symptoms of headache, the proportion of 55.0%, 89 patients had symptoms of gastrointestinal discomfort, the proportion of 44.5%. Other adverse reactions include paroxysmal atrial fibrillation, former frequent ventricular contraction, heart palpitations, liver and kidney dysfunction; for acute decompensated heart failure patients with a full range of care measures include four areas： basic care, health knowledge propaganda, psychological care and medication rules and care, protection of acute decompensated heart failure patients with a smooth recovery. Conclusion： The treatment of acute decompensated heart failure drugs are many, need to choose the right drug for treatment based on individual differences. Common adverse reactions to the disease mainly hypotension, hypokalemia, tachycardia, headache, gastrointestinal discomfort, seriously affecting the patient＇s physical and mental health. Nurses need to make a full range of nursing interventions to ensure the smooth recovery of patients, providing patient cure rate.