CAJ | 학술논문

目的：探讨分析内科老年重症心力衰竭患者临床治疗方案，为该病的临床治疗策略制定提供参考。方法收集2012年1月至2014年6月我院收治的老年重症心力衰竭患者120例，随机分成2组，观察组60例和对照组60例，对照组患者给予硝普钠、强心剂、利尿剂等进行常规治疗，观察组在常规治疗的基础上，加服厄贝沙坦氢氯噻嗪联合美托洛尔治疗，观察比较2组患者接受治疗半年和1年后，心功能分级、左心室射血分数、B型脑钠肽改善情况以及1年随访期间，患者的住院次数、住院天数和病死率。结果观察组患者治疗前心功能分级、左心室射血分数和 B 型脑钠肽指数和对照组比较，差异没有统计学意义（ P ＞0?05）；治疗后2组患者3项指标均较治疗前有明显改善，观察组改善情况明显优于对照组，2组比较差异均有统计学意义（ P ＜0?05）；2组患者在1年随访期内，观察组患者住院次数、住院天数和病死率均明显低于对照组，2组比较差异有统计学意义（ P＜0?05）。结论在常规对症治疗老年重症心力衰竭基础上，早期使用厄贝沙坦氢氯噻嗪联合美托洛尔药物辅助治疗，能有效地提高治疗效果和改善患者预后。
목적：탐토분석내과노년중증심력쇠갈환자림상치료방안，위해병적림상치료책략제정제공삼고。방법수집2012년1월지2014년6월아원수치적노년중증심력쇠갈환자120례，수궤분성2조，관찰조60례화대조조60례，대조조환자급여초보납、강심제、이뇨제등진행상규치료，관찰조재상규치료적기출상，가복액패사탄경록새진연합미탁락이치료，관찰비교2조환자접수치료반년화1년후，심공능분급、좌심실사혈분수、B형뇌납태개선정황이급1년수방기간，환자적주원차수、주원천수화병사솔。결과관찰조환자치료전심공능분급、좌심실사혈분수화 B 형뇌납태지수화대조조비교，차이몰유통계학의의（ P ＞0?05）；치료후2조환자3항지표균교치료전유명현개선，관찰조개선정황명현우우대조조，2조비교차이균유통계학의의（ P ＜0?05）；2조환자재1년수방기내，관찰조환자주원차수、주원천수화병사솔균명현저우대조조，2조비교차이유통계학의의（ P＜0?05）。결론재상규대증치료노년중증심력쇠갈기출상，조기사용액패사탄경록새진연합미탁락이약물보조치료，능유효지제고치료효과화개선환자예후。
Objective To analyze the clinical treatment of elderly patients with severe heart fallure patients in the Department of Internal Medicine ,and to provide the reference for the clinical treatment of the disease .Meth‐ods From 2012 January to 2014 June in our hospital were treated patients with senile severe heart fallure 120 ca‐ses treatment ,comparative analysis .Treatment methods are as follows :120 cases were randomly divided into two groups ,the observation group of 60 cases and control cases 60 ,groups of patients using conventional heart fallure treatment method were given sodium nitroprusside ,cardiotonic ,diuretic and other drugs for conventional treat‐ment ,the observation group in the conventional treatment based on the given to patients ,add oral irbesartan and hydrochlorothiazide combination metoprolol treatment were compared between the two groups of patients ,receiv‐ing treatment for half a year and one year after the series ,cardiac function ,left ventricular ejection fraction ,B‐type natriuretic peptide and the improvement of 1 years of follow‐up ,times of hospitalization ,days of hospitaliza‐tion and mortality in patients with? Results To observe the heart function series ,left ventricular ejection fraction and B‐type natriuretic peptide index and compare to the control group ,the patients in the treatment group ,the difference was not statistically significant ( P > 0?05) ;three indicators of two groups of patients were improved significantly compared with before treatment ,the observation group significantly better than the control group , the two groups comparison ,the differences were statistically significant ( P < 0?05) ;two patients at 1 year fol‐low‐up ,to observe the length of hospital stay and mortality were significantly lower than the control group ,times of hospitalization ,patients ,comparing the two groups ,with statistically significant difference ( P < 0?05) .Con‐clusion The treatment of elderly severe heart fallure based on conventional symptomatic ,early use of irbesartan and hydrochlorothiazide combined with metoprolol medication assisted treatment ,can improve the treatment effect and improve the prognosis of the patients effectively.