个体化治疗对老年慢性心力衰竭住院患者预后的影响

The Effect of Individualized Treatment on the Prognosis of Elderly Patients with Chronic Heart Failure

目的:探讨老年综合评估干预后个体化治疗对老年慢性心力衰竭住院患者预后的影响,以期能为老年患者的健康保障提供借鉴。方法:将2014年1月至2016年1月期间220例CHF住院患者作为研究对象,按照随机数表法将其分为对照组与观察组,每组各110例。对照组进行常规药物治疗与对症治疗,观察组进行老年综合评估,并根据评估结果组织多学科诊疗制定个体性治疗方案。两组患者进行为期1年的随访,对死亡率、再入院率、急诊就诊率以及心功能、认知功能和生活质量等指标进行比较分析。结果:观察组死亡率、再入院率和急诊就诊率分别为8.18%、23.64%、16.36%,低于对照组19.09%、38.18%、30.00%(P<0.05);干预后观察组LVEF为(51.25±6.68),明显高于对照组(46.71±5.87)(P<0.05);C-MLHF评分为(37.61±6.51),明显低于对照组(45.51±5.59)(P<0.05);Mo CA评分为(24.51±2.87),明显高于对照组(22.59±2.91)(P<0.05)。结论:老年综合评估干预后个体化治疗能够显著降低老年慢性心力衰竭住院患者的死亡率、再入院率、急诊就诊率,提升心功能、认知功能和生活质量,改善患者预后,值得在临床上推广使用。

Objective： To investigate the effect of geriatric comprehensive assessment intervention on the prognosis of hospitalized elderly patients with chronic heart failure,so as to provide reference for the health protection of elderly patients. Methods： During the period of January 2014 to January 2016,220 inpatients with CHF were included in this study as the research object,randomly divided into control group and observation group,110 cases in each group. The control group was given routine drug treatment and symptomatic treatment,the observation group was given comprehensive evaluation of the elderly,and the multidisciplinary treatment was organized according to the evaluation results,and individual treatment program was formulated.Two groups of patients were followed up for 1 year. The mortality,readmission rate,emergency visit rate,cardiac function,cognitive function and quality of life were compared and analyzed. Results： The mortality,readmission rate and emergency visit rate of the observation group were 8.18%,23.64% and 16.36%,respectively,which were lower than 19.09%,38.18% and 30% of the control group（P 〈0.05）; After the intervention,the LVEF of the observation group was（51. 25 ± 6. 68）,which was significantly higher than that of the control group（46.71 ± 5. 87）（P 〈 0. 05）; The C-MLHF score was（37. 61 ＋ 6. 51）,which was significantly lower than that of the control group（45.51±5.59）（P 〈 0.05）; The Mo CA score was（24.51 ± 2.87）,which was significantly higher than that of the control group（22.59±2.91）（P 〈0.05）. Conclusion： The elderly intervention after comprehensive geriatric assessment can significantly reduce the mortality,readmission rate,emergency treatment rate,improve cardiac function,cognitive function and quality of life,and improve the prognosis of elderly patients with chronic heart failure,which is worthy of clinical use.