Effects of health concept model-based detailed behavioral care on mood and quality of life in elderly patients with chronic heart failure

BACKGROUND With the intensification of social aging,the susceptibility of the elderly population to diseases has attracted increasing attention,especially chronic heart failure(CHF)that accounts for a large proportion of the elderly.AIM To evaluate the application value of health concept model-based detailed behavioral care in elderly patients with CHF.METHODS This study recruited 116 elderly CHF patients admitted from October 2018 to October 2020 and grouped them according to the nursing care that they received.The elderly patients who underwent health concept model-based detailed behavioral care were included in a study group(SG;n=62),and those who underwent routine detailed behavioral nursing intervention were included as a control group(CG;n=54).Patients’negative emotions(NEs),quality of life(QoL),and nutritional status were assessed using the self-rating anxiety/depression scale(SAS/SDS),the Minnesota Living with Heart Failure Questionnaire(MLHFQ),and the Modified Quantitative Subjective Global Assessment(MQSGA)of nutrition,respectively.Differences in rehabilitation efficiency,NEs,cardiac function(CF)indexes,nutritional status,QoL,and nursing satisfaction were comparatively analyzed.RESULTS A higher response rate was recorded in the SG vs the CG after intervention(P<0.05).After care,the left ventricular ejection fraction was higher while the left ventricular end-diastolic dimension and left ventricular end systolic diameter were lower in the SG compared with the CG(P<0.05).The post-intervention SAS and SDS scores,as well as MQSGA and MLHFQ scores,were also lower in the SG(P<0.05).The SG was also superior to the CG in the overall nursing satisfaction rate(P<0.05).CONCLUSION Health concept model-based detailed behavioral care has high application value in the nursing care of elderly CHF patients,and it can not only effectively enhance rehabilitation efficiency,but also mitigate patients’NEs and improve their CF and QoL.

Neutrophil-to-lymphocyte ratio compared to N-terminal pro-brain natriuretic peptide as a prognostic marker of adverse events in elderly patients with chronic heart failure

Background The neutrophil-to-lymphocyte （N/L） ratio has been associated with poor prognosis in patients with heart failure, but it has not been compared with N-terminal pro-brain natriuretic peptide （NT-proBNP） in elderly patients with chronic heart failure （CHF）. We sought to make this comparison. Methods A total of 1355 elderly patients with CHF were analyzed. A multivariate logistic regression model was used to analyze the variables associated with atrial fibrillation （AF）. Cox regression analysis was used to assess the multivariable rela- tionship between the N/L ratio, NT-proBNP level, and subsequent major cardiovascular events （MCE）. Results In the multiple logistic regression analysis, the N/L ratio was demonstrated as a risk factor for AF in elderly patients with CHF [odds ratio （OR）： 1.079, 95% confi- dence interval （CI）： 1.027-1.134, P = 0.003]. The median follow-up period was 18 months. In a multivariable model using tertiles of both variables, the highest tertile of the N/L ratio was significantly associated with MCE [hazard ratio （HR）： 1.407, 95% CI： 1.098-1.802, P = 0.007] compared with the lowest tertile. Similarly, the highest NT-proBNP tertile was also significantly associated with MCE （HR： 1.461, 95% CI： 1.104-1.934, P- 0.008）. Conclusions In elderly patients with CHF, the N/L ratio is one of the important risk factors for AF and it is an inexpensive and readily available marker with similar independent prognostic power to NT-proBNP. The risk of MCE increases 1.407-fold when the N/L ratio is elevated to the highest tertile.

Additive Benefits of Twice Forest Bathing Trips in Elderly Patients with Chronic Heart Failure

Chronic heart failure （CHF）, a clinical syndrome resulting from the consequences of various cardiovascular diseases （CVDs）, is increasingly becoming a global cause of morbidity and mortality. We had earlier demonstrated that a 4-day forest bathing trip can provide an adjunctive therapeutic influence on patients with CHF. To further investigate the duration of the impact and the optimal frequency of forest bathing trips in patients with CHF, we recruited those subjects who had experienced the first forest bathing trip again after 4 weeks and randomly categorized them into two groups, namely, the urban control group （city） and the forest bathing group （forest）. After a second 4-day forest bathing trip, we observed a steady decline in the brain natriuretic peptide levels, a biomarker of heart failure, and an attenuated inflammatory response as well as oxidative stress. Thus, this exploratory study demonstrated the additive benefits of twice forest bathing trips in elderly patients with CHF, which could further pave the way for analyzing the effects of such interventions in CVDs.

Beta-blocker therapy in elderly patients with renal dysfunction and heart failure

OBJECTIVE To assess the role of beta-blockers(BB)in patients with chronic kidney disease(CKD)aged≥75 years.METHODS AND RESULTS From January 2008 to July 2014,we included 390 consecutive patients≥75 years of age with ejection fraction≤35%and glomerular filtration rate(GFR)≤60 m L/min per 1.73 m^2.We analyzed the relationship between treatment with BB and mortality or cardiovascular events.The mean age of our population was 82.6±4.1 years.Mean ejection fraction was 27.9%±6.5%.GFR was 60-45 m L/min per 1.73 m^2 in 50.3%of patients,45-30 m L/min per 1.73 m^2 in 37.4%,and<30 m L/min per 1.73 m^2 in 12.3%.At the conclusion of follow-up,67.4%of patients were receiving BB.The median follow-up was28.04(IR:19.41-36.67)months.During the study period,211 patients(54.1%)died and 257(65.9%)had a major cardiovascular event(death or hospitalization for heart failure).BB use was significantly associated with a reduced risk of death(HR=0.51,95%CI:0.35-0.74;P<0.001).Patients receiving BB consistently showed a reduced risk of death across the different stages of CKD:stage IIIa(GFR=30-45 m L/min per 1.73 m^2;HR=0.47,95%CI:0.26-0.86,P<0.0001),stage IIIb(GFR 30-45 m L/min per 1.73 m^2;HR=0.55,95%CI:0.26-1.06,P=0.007),and stages IV and V(GFR<30 m L/min per 1.73 m~2;HR=0.29,95%CI:0.11-0.76;P=0.047).CONCLUSIONS The use of BB in elderly patients with HFr EF and renal impairment was associated with a better prognosis.Use of BB should be encouraged when possible.

Prevalence of iron deficiency in patients aged 75 years or older with heart failure

Background The latest studies presented at the American Heart Association (AHA) meeting on heart failure and the update of the European Cardiology Society’s (ECS) recommendations on heart failure in 2016 recommend intravenous iron supplementation in patients with heart failure, reduced ejection fraction and iron deficiency for improves walking performance and quality of life, and reduces morbidity. In the present study, we investigated the prevalence of iron deficiency in heart failure patients aged 75 years or older, as there is currently no data on these patients. Methods We performed an observational study on hospitalized patients in Geriatric Cardiology Department. Among the 462 patients hospitalized during eight months, 176 were eligible for inclusion;22 patients was significant interference with an inflammatory syndrome (high ferritin with high C-reactive protein), and for 13 patients iron-related data were not available. For each patient included, a complete iron assessment and type of heart failure was available. Results A total of 141 patients were included, the mean age was 88 years (range: 75–101), and there were 52 (36.9%) of patients with reduced ejection fraction (EF), 37 (26.2%) with mid-range EF, and 52 (36.9%) with preserved EF. Irrespective of heart failure type, 73.8% had iron deficiency (95% CI: 65.7%–80.8%);this was found in 57.7%(95% CI: 43.2%–71.3%) of those with reduced EF, 78.4%(95% CI: 61.8%–90.2%) of those with mid-range EF, and 86.5%(95% CI: 74.2%–94.4%) of those with preserved EF (P = 0.003). Conclusion The prevalence of iron deficiency was very high in very elderly patients with heart failure, especially those with HF with mid-range EF or HF with preserved EF.

Precipitating factors leading to decompensation of chronic heart failure in the elderly patient in South-American community hospital

Background Exacerbations of heart failure appear frequently associated with precipitating factors not directly related to the evolution of cardiac disease. There still a paucity of data on the proportional distribution of precipitating factors specifically in elderly patients. The aim of this study was to examine prospectively the precipitating factors leading to hospitalization in elderly patients with heart failure in our community hospital. Methods We evaluate elderly patients who need admissions for decompensate heart failure. All patients were reviewed daily by the study investigators at the first 24 h and closely followed-up. Decompensation was defined as the worsening in clinical NYHA class associated with the need for an increase in medical treatment （at minimum intravenously diuretics）. Results We included 102 patients （mean age 79 ± 12 years）. Precipitating factors were identified in 88.5%. The decompensation was sudden in 35% of the cases. Noncompliance with diet was identified in 52% of the patients, lack of adherence to the prescribed medications amounted to 30%. Others precipitating factors were infections （29%）, arrhythmias （25%）, acute coronary ischemia （22%）, and uncontrolled hypertension （15%）, miscellaneous causes were detected in 18% of the cases （progression of renal disease 60%, anemia 30% and iatrogenic factors 10%）. Concomitant cause was not recognizable in 11.5%. Conclusions Large proportion heart failure hospitalizations are associated with preventable precipitating factors. Knowledge of potential precipitating factors may help to optimize treatment and provide guidance for patients with heart failure. The presence of potential precipitating factors should be routinely evaluated in patients presenting chronic heart failure.

Cardiac resynchronization therapy in the elderly heart failure patient

Ms. BP is an 83 year old white female with a long history of congestive heart failure (HF). She is now symptomatic with minimal exertion, has a left ventricular ejection fraction (LVEF) of 20%. Her CHF is due to hypertension (HTN) plus coronary artery disease (CAD) and she is on angiotensin converting enzyme inhibitor (ACEI), furosemide, digoxin,spironolactone, low dose beta blocker and nitrates. Her beta-natriuretic peptide (BNP) in clinic is 3030 pg/ml, heart rate (HR) 100, blood pressure (BP) 89/43.

Management of chronic heart failure in the older population

Chronic heart failure （CHF） is the leading cause of hospitalization for those over the age of 65 and represents a significant clinical and economic burden. About half of hospital re-admissions are related to co-morbidities, polypharmacy and disabilities associated with CHF. Moreover, CHF also has an enormous cost in terms of poor prognosis with an average one year mortality of 33%–35%. While more than half of patients with CHF are over 75 years, most clinical trials have included younger patients with a mean age of 61 years. Inadequate data makes treatment decisions challenging for the providers. Older CHF patients are more often female, have less cardiovascular diseases and associated risk factors, but higher rates of non-cardiovascular conditions and diastolic dysfunction. The prevalence of CHF with reduced ejection fraction, ischemic heart disease, and its risk factors declines with age, whereas the prevalence of non-cardiac co-morbidities, such as chronic renal failure, dementia, anemia and malignancy increases with age. Diabetes and hypertension are among the strongest risk factors as predictors of CHF particularly among women with coronary heart disease. This review paper will focus on the specific consideration for CHF assessment in the older population. Management strategies will be reviewed, including non-pharmacologic, pharmacologic, quality care indicators, quality improvement in care transition and lastly, end-of-life issues. Palliative care should be an integral part of an interdiscipli-nary team approach for a comprehensive care plan over the whole disease trajectory. In addition, frailty contributes valuable prognostic in-sight incremental to existing risk models and assists clinicians in defining optimal care pathways for their patients.

Left ventricular assist devices as destination therapy in stage D heart failure

1 Introduction? Mechanical circulatory support (MCS) has increasingly become an important management opportunity for patients with stage D heart failure (HF) with remarkable impact on patient survival and quality of life. Early clinical trials have demonstrated improved outcomes of durable left ventricular assist device (LVAD) support compared with optimal medical management.[1] As technology advanced, continuous flow LVADs outperformed pulsatile flow devices in clinical trials and the field migrated to HeartMate (Abbott Laboratories, Abbott Park, IL) and HeartWare (Medtronic, Minneapolis, MN) devices due to their clinical superiority. Among the continuous flow devices.

Respiratory and Cardiac Characteristics of ICU Patients Aged 90 Years and Older:A Report of 12 Cases

Objective To investigate the respiratory and cardiac characteristics of elderly Intensive Care Unit （ICU） patients. Methods Twelve senior ICU patients aged 90 years and older were enrolled in this study. We retrospectively collected all patients＇ clinical data through medical record review. The basic demographics, primary cause for admission, the condition of respiratory and circulatory support, as well as prognosis were recorded. Shock patients and pneumonia patients were specifically analyzed in terms of clinical manifestations, laboratory variables, echocardiography, and lung ultrasound results. Results The mean age of the included patients was 95 years with a male predominance （8 to 4, 66.7%）. Regarding the reasons for admission, 6 （50.0%） patients had respiratory failure, 1 （8.3%） patient had shock, while 5 （41.7%） patients had both respiratory failure and shock. Of the 6 patients who suffered from shock, only 1 was diagnosed with distributive shock, 5 with cardiogenic shock. Of the 5 cardiogenic shock patients, 1 was diagnosed with acute coronary syndrome. The rest 4 cardiogenic shock patients were diagnosed with Takotsubo cardiomyopathy. The patient with ST-segment elevation myocardial infarction died within 24 hours. Of the 4 Takotsubo patients, 1 died on day-6 and the other 3 patients were transferred to ward after heart function recovered in 1 to 2 weeks. Of the 10 pneumonia patients, 3 were diagnosed as community acquired pneumonia, and 7 as hospital acquired pneumonia. Only 3 patients were successfully weaned from ventilator. The others required long-term ventilation complicated with heart failure, mostly with diastolic heart failure. Lung ultrasound of 6 during spontaneous breathing trial. patients with diastolic dysfunction showed bilateral B-lines Conclusions Elderly patients in shock tend to develop Takotsubo cardiomyopathy. Diastolic heartdysfunction might be a major contributor to difficult weaning from ventilator in elderly patients. Bedside lung ultrasonography and echocardiography could help decide the actual cause of respiratory failure and shock more accurately and effectively.

Features and clinical nursing of heart failure in elderly patients during perioperative period

Heart failure is a common condition in elderly patients.With further population aging,incidence of heart failure is constantly increasing.When heart failure occurs in this group of patients,clinical symptoms may vary vastly,rendering difficulty for the treatment process and leading to poor efficacy and prognosis.To gain better under-standing on clinical symptoms and signs of heart failure in elderly patients,to provide prevention and treatment against heart failure for elderly patients in terms of nursing care and to improve success rate of salvage treatment as well as nurs-ing quality.Methods Retrospective analysis was performed in 141 patients with heart failure who were treated in our hospital during January 2005 and December 2009.Those aged > 60 years were assigned to elderly group while those aged < 60 years were assigned to non elderly group.These two groups were compared in terms of clinical symptoms, signs and physical and laboratory examinations.Results Clinical symptoms and signs of heart failure tended to be a-typical in elderly patients.Symptoms including cough,sputum,increased heart rate and mental disorder were frequent, and a substantial proportion of patients had pulmonary congestion and edema.Conclusions Prevention and specific nursing measures should be aggressively taken based on the features of heart failure in elderly patients.Frequency of in-spection particularly observation on atypical symptoms should be increased to provide intensive monitoring.

Follicular lymphoma with cardiac involvement in a 90-year-old patient:A case report

BACKGROUND The incidence of cardiac lymphoma is low,and it mainly occurs secondary to nonHodgkin’s lymphoma,particularly diffuse large B-cell lymphoma.Here,we report a case of follicular lymphoma with cardiac involvement and severe heart failure as the sole clinical manifestation.CASE SUMMARY A 90-year-old male patient was first admitted to our hospital due to an accidentally discovered painless mass in the right lower abdomen.A biopsy of the mass revealed a follicular lymphoma.Positron emission tomography-computed tomography confirmed mild pericardial effusion,and echocardiography showed no structural abnormalities with normal ejection fraction at the time of diagnosis.The patient refused our recommendation of chemotherapy and was re-admitted 4 mo later due to heart failure.A series of subsequent echocardiographic examinations showed thickening of the left ventricular walls and increasing pericardial effusion over the following 2 mo.His heart failure exacerbated despite all symptomatic and supportive treatments.He passed away after an episode of aspiration pneumonia.CONCLUSION The diagnosis of cardiac lymphoma is difficult as its clinical manifestations are nonspecific,and prognosis is poor.

基于Kano模型的老年重度慢性心力衰竭住院患者灵性照护需求现状及其属性分析

目的对老年重度慢性心力衰竭(CHF)住院患者灵性照护需求现状及其属性进行分析研究,为满足患者灵性照护需求,提高灵性照护质量提供参考和方向。方法2021年12月—2022年7月,使用一般资料调查表、患者灵性照护需求量表、基于Kano模型的患者灵性照护需求量表对天津市某三级甲等医院的381例老年重度CHF住院患者进行调查研究。结果老年重度CHF住院患者灵性照护需求总分为29.75±5.74分。灵性照护需求12个条目中,惊喜属性为3条,且都在保留区Ⅳ;线性属性为5条,其中3条位于优势区Ⅰ,2条位于待改进区Ⅱ;基本属性为2条,均处于待改进区Ⅱ;无关属性为2条,均处于次要改进区Ⅲ。在“分享自我感悟”维度中,惊喜和线性属性均为2条,基本属性为1条;在“帮助思考”维度中,线性和无关属性分别为2条、1条;在“营造良好氛围”维度中,惊喜和基本属性各占1条;在“探索精神信仰”维度中,线性属性1条;在“帮助宗教修行”维度中,无关属性1条。结论老年重度CHF住院患者灵性照护需求处于中等水平,且其基本、惊喜属性需求主要分布在“营造良好氛围”“分享自我感悟”维度,线性属性需求主要分布在“分享自我感悟”“帮助思考”维度。提示医院管理层应在巩固完善基本、线性属性灵性照护需求的前提下,进一步改造创新惊喜属性需求,从而优化分析无关属性需求。

多巴胺联合左西孟旦、硝普钠治疗老年重症心衰患者的疗效及安全性分析

目的分析老年重症心衰患者临床治疗中采取多巴胺、左西孟旦、硝普钠联合治疗的临床疗效及安全性。方法选取2020年6月—2022年1月期间北京燕化医院因重症心衰就诊的68例老年患者为研究对象。利用随机数表法分为对照组(采取硝普钠单一治疗)与研究组(采取多巴胺、左西孟旦、硝普钠联合治疗),每组34例。比较两组临床疗效及用药安全性。结果研究组治疗总有效率(91.18%)明显高于对照组(70.59%),差异有统计学意义(χ^(2)=4.660,P<0.05)。治疗后,研究组心功能指标和血清血浆标志物水平均优于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论在治疗老年重症心衰患者时采取多巴胺、左西孟旦、硝普钠联合治疗方案较单一硝普钠用药的临床疗效更好,可降低血清血浆标志物水平,改善心功能,避免发生急性心血管事件,并且联合用药后未明显增加不良反应发生风险,具有较好的用药安全性,建议推广。

β-受体阻滞剂通过线粒体氧化应激途径减轻老年重度心力衰竭患者心肌缺血再灌注损伤

目的探究β-受体阻滞剂是否会对老年重度心力衰竭患者的临床效果和生存质量造成影响。方法选择符合纳入要求的老年重度心力衰竭患者60例随机分为观察组和对照组2组,每组各30例患者,对照组和观察组分别通过常规药物利尿剂和洋地黄治疗、β-受体阻滞剂完成相应的治疗。评估治疗效果、生存质量和治疗期间药物带来的不良反应。在治疗后,通过超声心动图检测患者左室射血分数(LVEF)、左室舒张末期直径(LVEDd)、左室收缩末期直径(LVESd);利用实时PCR检测外周血过氧化物酶体增殖激活受体γ共激活因子1-α(PGC1α)、超氧化物歧化酶(SOD2)和柠檬酸合成酶(Cs)m RNA的表达量。结果观察组和对照组治疗总有效率分别为96.67%和80.00%,并且在治疗2周后观察组的生存质量显著优于对照组(P<0.05)。综合分析两组不良反应的发生率,差异则无统计学差异(P>0.05)。观察组LVEDd和LVESd明显低于对照组(P<0.05),LVEF显著高于对照(P<0.05);与对照组相比,观察组PGC1-a、SOD2和Cs基因的表达水平显著降低(P<0.05)。结论β-受体阻滞剂可减轻缺血再灌注所致线粒体的损伤,从而提高患者的治疗效果和生活质量。

连续性血液净化治疗老年顽固性心力衰竭疗效分析

目的探讨连续性血液净化治疗(CBP)老年顽固性心力衰竭(RHF)的疗效。方法应用CBP治疗35例老年RHF患者,检测治疗前后血压(BP)、心率(HR)、呼吸、血氧饱和度、血生化、血气分析、左心室射血分数(LVEF)等指标的变化和观察治疗效果。结果应用CBP治疗后患者水肿明显减轻,收缩压(SP)、舒张压(DP)下降,HR、呼吸减慢,血氧饱和度升高;血清钾、钠、氯恢复正常,尿素氮及血肌酐下降;血pH值、血碳酸氢根(HCO3-)升高,血氧分压(PaO2)升高;LVEF明显增加,心功能明显改善,差异有统计学意义(P<0.01,P<0.05)。结论CBP能有效纠正老年RHF患者水、电解质、酸碱平衡紊乱,纠正心力衰竭,短期效果佳。

老年心力衰竭患者心功能与血浆脑钠肽N末端前体、肌钙蛋白T及左心室射血分数的关系

目的探讨老年心力衰竭(EH)患者血浆脑钠肽N末端前体(NT-proBNP)、肌钙蛋白T(cTNT)与左室射血分数(LVEF)的相关性。方法选择我院心内科80例老年心衰患者作为观察组,体检中心体检正常的80例作为对照组。检测两组患者血浆NT-proBNP、cTNT水平,运用彩色多普勒超声进行LVEF测定,并进行相关性分析。结果心衰组NT-proBNP较对照组显著升高,两组指标差异有统计学意义(P<0.01),cTNT较对照组显著升高,两组指标差异有统计学意义(P<0.05),LVEF较对照组显著降低,呈负相关,两组指标差异有统计学意义(P<0.05)。NT-proBNP在各级心功能不全之间对比,差异有统计学意义(P<0.05)。cTnT、LVEF在心功能Ⅱ～Ⅲ级与心功能Ⅳ级之间对比,差异有统计学意义(P<0.05)。结论心力衰竭患者血浆脑钠肽N末端前体和肌钙蛋白随着心力衰竭程度的加重而相应升高,左室射血分数明显减低。

连续性血液净化治疗老年重症心力衰竭疗效分析

目的观察连续性血液净化(CBP)治疗老年重症心力衰竭的临床疗效。方法对我院2009年1月至2011年3月CBP治疗的32例老年重症心力衰竭患者的临床资料进行回顾性分析。观察患者治疗前与治疗后24、48、72 h血生化、血气分析、血压、呼吸、心率、氧合指数和左心室射血分数等指标的变化和治疗效果。结果 32例患者显效27例,有效4例,死亡1例,总有效率为96.8%,CBP治疗后31例患者心功能明显改善、水肿明显消退、肺部湿啰音明显减少,血压偏高者有所下降,所有患者治疗后24、48、72 h心率、呼吸、中心静脉压、平均动脉压、氧合指数、血尿素氮、血肌酐及水电酸碱失衡情况与治疗前比较差异均有统计学意义(P<0.01)。结论 CBP技术治疗老年重症心力衰竭患者临床疗效肯定,不良反应发生率低。

芪苈强心胶囊对老年重度心力衰竭患者的疗效观察

目的对老年重度慢性心力衰竭患者给予芪历强心胶囊治疗,并观察其临床治疗效果。方法选取2016年10月-2017年1月在第二军医大学附属长海医院50例老年慢性心力衰竭(chronic heartfailure,CHF)患者,按人院先后随机分为治疗组和对照组,各25例,对照组给予常规西药治疗,治疗组在对照组基础上加用芪苈强心胶囊,连续治疗90 d,对比2组治疗前后左室射血分数(1eft ventricular ejection fraction,LVEF)、左室舒张末期内径(1eft ventricular end diastolic diameter,LVEDD),血浆N末端脑钠肽前体(N terminal pro B type natriuretie peptide,NT-ProBNP)及临床疗效。结果治疗90d后,两组患者的血浆NT-proBNP均发生明显降低,治疗组相比于对照组降幅更明显(P=0.0327),NT-proBNP降低至少30%的患者比例为60%,对照组为44%(P=0.0094)。此外,治疗组在左心室射血分数、左心室舒张末期内径等方面的改善优于对照组(P<0.05)。结论芪苈强心胶囊联合常规西药治疗能增强老年极重度心衰患者心功能,有助于改善预后。

54例老年急性左心衰竭患者的护理探讨

目的:探讨老年急性左心衰竭患者的临床特点及抢救护理体会。方法:对54例老年急性左心衰竭患者临床特点进行前瞻性分析。结果:54例患者中,明确诱因引起急性左心衰竭者52例(96.2%),其中肺部感染为诱因的27例(50.0%),合并症则以合并肺部感染和心血管疾病为主。结论:护理人员注意预防老年急性左心衰竭患者的各种诱因,熟悉治疗急性左心衰竭的各种药物及其不良反应,严密观察病情变化,积极进行心理护理和健康宣教,对急性左心衰竭的成功防治具有重要意义。