重症肺炎合并慢性心功能不全老年患者的诊疗体会

Retrospective analysis the role of chronic heart insufficiency in elderly patient with severe pneumonia

目的探讨老年重症肺炎合并心功能不全患者的有效诊疗方法。方法选取2015年1月1日至2015年12月31日我院重症医学科收治的老年重症肺炎患者30例,对其临床特点及诊治过程进行回顾分析。结果老年重症肺炎患者常伴有不同程度的心功能不全,临床缺乏典型心衰肺水肿表现,经过在抗感染基础上重点加强改善心功能治疗后,病情可有明显好转,住院时间缩短,预后得到改善。结论老年重症肺炎患者心功能不全发生率高,临床表现不典型。老年重症肺炎患者住院期间合并慢性心衰的风险显著增加,早期启动适当的抗生素治疗是成功的关键,在正规抗感染基础上,加强改善心功能治疗,可促进总体病情改善。

Objective To investigate the role of chronic heart insufficiency in elderly patient with severe pneumonia. Methods All the medical records of 30 elderly patients with severe pneumonia from January 2015 to December 2015 in the Daping Hospital were searched. Clinical characteristics,age,basic disease,clinical symptoms were analyzed. Results Elderly patients with severe pneumonia are often accompanied by varying degrees of cardiac insufficiency,clinical manifestation of the lack of typical pulmonary edema in heart failure. Patients in anti infection based on the focus to strengthen the improvement of heart function after treatment,the condition can be improved significantly,the length of stay in hospital is shortened,and the prognosis is improved. Conclusions Early initiation of appropriate antibiotic based upon the knowledge of local resistant patterns of existing pathogens is the key for successful treatment. Patients with severe pneumonia have markedly increased risk of hospitalization with chronic heart insufficiency.