老年重症心力衰竭急诊内科治疗的临床效果研究

Clinical Effect of Emergency Internal Medicine in Elderly Patients With Severe Heart Failure

目的评价老年重症心力衰竭急诊内科治疗的临床效果,分析治疗要点。方法 2014年2月—2015年12月,医院急诊内科收治老年人重症心力衰竭患者70例。结果治疗后,患者尿量、血钾、血钠、SBP、HR、RR、APACHEⅡ评分低于治疗前,PaO_2/FiO_2、CO、E/A高于治疗前,差异有统计学意义(P<0.05)。并发休克率15.71%,新发心律失常发生率7.14%,抢救成功率94.29%(66/70),4例死亡患者均死于猝死。结论老年重症心力衰竭急诊内科治疗的关键在于预防、及时处置猝死,用药需规范,做好尿量、体征等指标检测,调整用药。

Objective To evaluate the clinical effect of emergency internal medicine in the treatment of severe heart failure in elderly patients and to analyze the main points of treatment.Methods From February 2014 to December 2015,70 elderly patients with severe heart failure were treated in emergency internal medicine.Results After treatment,the urine volume,serum potassium,blood sodium,SBP,HR,RR,APACHE II scores were lower than before treatment,PaO_2/FiO_2,CO and E/A were higher than before treatment,the difference was statistically significant（P〈0.05）.The complication rate was 15.71%,incidence of new arrhythmia was 7.14%,rescue success rate was 94.29%（66/70）,4 patients died of sudden death.Conclusion The key to the emergency internal medicine in the treatment of severe heart failure is to prevent and timely deal with sudden death.The medication should be standardized,and the urine volume,signs and other indicators should be well adjusted and adjusted.