常规治疗与急诊内科治疗心力衰竭临床疗效对比分析

Conventional Treatment and Emergency Medical Treatment of Heart Failure Clinical Curative Effect Analysis

目的研究常规治疗与急诊内科治疗心力衰竭患者病例的治疗后临床效果、治疗前后心率、左室射血分数、收缩压、舒张压以及治疗后心功能分级情况。方法从2013年4月至2014年1月,选取我院的96例老年心力衰竭患者临床资料进行回顾性分析,将其分为观察组和对照组,其中观察组48例患者,在常规治疗的基础上联合给予美托洛尔和厄贝沙坦氢氯噻嗪治疗,对照组48例患者,只进行常规治疗。分析两组患者治疗后临床效果、治疗前后心率、左室射血分数、收缩压、舒张压以及治疗后心功能分级情况。结果两组患者疗效对比,观察组显效率为66.67%(32/48),有效率为91.67%(44/48),均显著高于对照组的91.67%(44/48)和50.00%(24/48),差异均有统计学意义(P<0.05);观察组一级占比25.00%(12/48),二级占比33.33%(16/48),三级占比25.00%(12/48),四级占比16.67%(8/48)。对照组一级占比0.00%(0/48),二级占比54.17%(26/48),三级占比45.83%(22/48),四级占比66.67%(32/48),差异均有统计学意义(P<0.05);两组治疗前血压、心率及左室射血分数平均无统计学差异(P>0.05),治疗后两组的舒张压、收缩压及左室射血分数平均较治疗前显著提高(P<0.05),但观察组显著高于对照组(P<0.05),更接近正常水平;两组治疗后心率均显著降低(P<0.05),但观察组显著低于对照组(P<0.05),更接近正常水平。结论临床上对于急诊内科老年重症心力衰竭患者,通过采用在常规治疗的基础上用美托洛尔及厄贝沙坦氢氯噻嗪进行治疗疗效显著,值得临床治疗参考。

Objective To study the conventional treatment,emergency medical treatment and clinical effect after the treatment of patients with heart failure cases,HR before and after the treatment,LVEF Hou Xin function classification,SBP,DBP,and treatment. Methods From April 2013 to January 2014,to choose our hospital 96 cases of senile heart failure patients were retrospectively analyzed,it can be divided into observation group and control group in the two groups,one group of 48 patients,on the basis of routine therapy for Metoprolol and Irbesartan- hydrochlorothiazide treatment,control group of 48 patients,only for regular treatment,analyzed two groups after treatment in patients with clinical effect,heart rate,left ventricular ejection fraction before and after the treatment,systolic pressure,diastolic pressure and treatment Hou Xin function classification. Results Two groups of patients with curative effect comparison,observation group were 66. 67%（ 32 /48）,effective rate was 91. 67（ 44 /48）,were significantly higher than that of control group 91. 6%（ 44 /48）,50. 00%（ 24 /48）,the difference had statistical significance（ P〈0. 05）; Observation group level accounted for 25. 00%（ 12 /48）,secondary accounted for 33. 33%（ 16 /48）,tertiary accounted for 25. 00%（ 12 /48）,4 class accounted for 16. 67%（ 8 /48）. Control level accounted for 0. 00%（ 0 /48）,tertiary accounted for 54. 17%（ 26 /48）,4 class accounted for 45. 83%（ 22 /48）,level accounted for 66. 67%（ 32 /48）,the difference had apparent statistical significance（ P〈0. 05）;The two groups before treatment of blood pressure,heart rate and left ventricular ejection fraction,on average,no significant difference（ P〉0. 05）,the two groups after treatment of diastolic and systolic blood pressure and left ventricular ejection fraction,on average,compared with preoperative significantly increased（ P〈0. 05）,but the observation group is significantly higher than the control group（ P〈0. 05）,more close to normal; Two groups of heart rate after treatment were significantly lower（ P〈0. 05）,but the observation group was significantly lower than the control group（ P〈0. 05）,the more close to normal. Conclusion For clinical emergency medicine in elderly patients with severe heart failure,by adopting the conventional treatment on the basis of Metoprolol and Irbesartan- hydrochlorothiazide treatment curative effect is distinct,is worth reference in the clinical practice.