老年重症心力衰竭急诊内科的治疗方法与治疗效果观察

Observation on the treatment method and effect of emergency internal medicine for severe heart failure in the elderly

目的探究老年重症心力衰竭急诊内科的治疗方法与治疗效果。方法 75例重症心力衰竭老年患者,以随机的方式分成对照组(37例)及观察组(38例)。对照组采用常规治疗,观察组在常规治疗的同时适当应用硝普钠、美托洛尔和厄贝沙坦氢氯噻嗪治疗。比较两组患者的治疗效果,治疗前后的心功能指标[脑钠肽(BNP)和左室射血分数(LVEF)]。结果观察组治疗总有效率为94.74%,高于对照组的75.68%,差异具有统计学意义(P<0.05)。治疗前,两组患者的BNP、LVEF比较,差异均无统计学意义(P>0.05);治疗后,两组患者的BNP均较本组治疗前降低, LVEF均较本组治疗前升高,且观察组BNP(745.7±56.3)pg/ml低于对照组的(956.4±135.8)pg/ml, LVEF(37.1±1.8)%高于对照组的(33.2±2.5)%,差异均具有统计学意义(P<0.05)。结论老年重症心力衰竭患者在急诊内科常规治疗方案的基础上应用硝普钠、美托洛尔、厄贝沙坦氢氯噻嗪能使患者的心功能明显改善,治疗效果突出,值得临床推广应用。

Objective To investigate the treatment method and effect of emergency internal medicine for severe heart failure in the elderly. Methods A total of 75 elderly patients with severe heart failure were randomly divided into control group(37 cases) and observation group(38 cases). The control group received conventional therapy, and the observation group received sodium nitroprusside, metoprolol, irbesartan and hydrochlorothiazide for treatment on the basis of conventional therapy. The therapeutic effect, cardiac function indicators [brain natriuretic peptide(BNP) and left ventricular ejection fraction(LVEF)] before and after treatment were compared between the two groups. Results The total effective rate of the observation group was 94.74%, which was higher than that of the control group 75.68%, and the difference was statistically significant(P<0.05). Before treatment, there was no statistically significant difference in BNP and LVEF between the two groups(P>0.05). After treatment, BNP of the two groups was lower than those before treatment of the same group, LVEF was higher than that before treatment of the same group. BNP(745.7±56.3) pg/ml of the observation group was lower than that of the control group(956.4±135.8) pg/ml, and LVEF(37.1±1.8)% was higher than that of the control group(33.2±2.5)%, and the difference was statistically significant(P<0.05). Conclusion Application of sodium nitroprusside, metoprolol, irbesartan and hydrochlorothiazide in the elderly patients with severe heart failure on the basis of conventional emergency internal medicine can significantly improve the cardiac function of elderly patients with severe heart failure, and the therapeutic effect is outstanding, which is worth recommending in clinical practice.