CAJ | 학술논문

目的对比分析ICU和常规治疗对老年缺血性心力衰竭的临床效果及患者心理状态的差异,提出临床治疗新方案.方法连续选择2013年6月至2014年6年来我院心内科诊断为缺血性心力衰竭患者共64例,该研究取得我院伦理委员会通过及患者、家属的知情同意权后,将其随机分为试验组和对照组各32例,试验组患者进入ICU治疗,对照组患者进入普通病房治疗,对比分析两组患者的心脏功能指标、临床效果及患者抑郁焦虑量表评分的差异性.结果治疗后两组患者的左心室舒张末期内径、左心室射血分数和心脏NYHA分级均有改善,且试验组改善的更明显[左心室舒张末期内径:(56.7±4.1)mm与(59.2±4.6) mm,左心室射血分数:0.49.7±0.05与0.42±0.04,NYHA Ⅰ级:23与22,NYHAⅡ、Ⅲ级:11与17;t值分别为3.105、3.416,x2值分别为0.714、3.513,P均＜0.05].试验组患者的住院时间和住院费用均比对照组显著减少(t值分别为3.846、3.913,P均＜0.05),两组患者的治疗方式(选择支架植入、冠状动脉搭桥和单纯药物治疗)比较差异无统计学意义(P均＞0.05);试验组患者的院内病死率和随访病死率分别为9.4％和12.5％,均显著低于对照组的21.9％和28.1％(x2值分别为3.102、3.715,,P均＜0.05).治疗后两组患者的抑郁焦虑量表评分均升高,且对照组升高的更明显(t值分别为,3.326、3.845,P均＜0.05).结论针对病情较重的老年缺血性心力衰竭患者给予ICU专科治疗,可显著提高临床效果和减少抑郁焦虑状态.
목적 대비분석ICU화상규치료대노년결혈성심력쇠갈적림상효과급환자심리상태적차이,제출림상치료신방안.방법 련속선택2013년6월지2014년6년래아원심내과진단위결혈성심력쇠갈환자공64례,해연구취득아원윤리위원회통과급환자、가속적지정동의권후,장기수궤분위시험조화대조조각32례,시험조환자진입ICU치료,대조조환자진입보통병방치료,대비분석량조환자적심장공능지표、림상효과급환자억욱초필량표평분적차이성.결과 치료후량조환자적좌심실서장말기내경、좌심실사혈분수화심장NYHA분급균유개선,차시험조개선적경명현[좌심실서장말기내경:(56.7±4.1)mm여(59.2±4.6) mm,좌심실사혈분수:0.49.7±0.05여0.42±0.04,NYHA Ⅰ급:23여22,NYHAⅡ、Ⅲ급:11여17;t치분별위3.105、3.416,x2치분별위0.714、3.513,P균＜0.05].시험조환자적주원시간화주원비용균비대조조현저감소(t치분별위3.846、3.913,P균＜0.05),량조환자적치료방식(선택지가식입、관상동맥탑교화단순약물치료)비교차이무통계학의의(P균＞0.05);시험조환자적원내병사솔화수방병사솔분별위9.4％화12.5％,균현저저우대조조적21.9％화28.1％(x2치분별위3.102、3.715,,P균＜0.05).치료후량조환자적억욱초필량표평분균승고,차대조조승고적경명현(t치분별위,3.326、3.845,P균＜0.05).결론 침대병정교중적노년결혈성심력쇠갈환자급여ICU전과치료,가현저제고림상효과화감소억욱초필상태.
Objective To compare effect and psychological state between ICU and conventional treatment in elderly patients with ischemic heart failure.Methods A total of 64 consecutives diagnosed as ischemic heart failure in the Second Center Hospital of Baoding from June 2013 to June 2014 were divided randomly into experiment and control group, each of 32 cases, after getting approval of our hospital's ethics committee and informed consent right of patients ,family members.The patients in experiment group were advised into ICU, and the patients in control group were into common ward, then compared the differences of cardiac functions,clinical effect and scale anxiety score (SAS), scale depression score (SDS).Results The left ventricular end diastolic diameter (LVEDd), ejection fraction (EF) and NYHA class in the two groups after treatment were both better than before, and the experiment group were significantly better than the control group (LVEDd: (56.7±4.1) mm vs.(59.2 ± 4.6) mm;EF : 0.49 ± 0.05 vs.0.42 ± 0.04;NYHAI degree: 23 vs 22;NYHA Ⅱ-Ⅲ degree: 11 vs 17;t =3.105,3.416;x2 =0.714,3.513;P＜0.05).The in-hosptical days and fees in experiment group were significantly less than the control group(t =3.846,3.913;P＜0.05).The treatment types in the two groups were no statistical difference (P ＞ 0.05).The death rate in-hosptical and follow-up in experiment group were both significantly lower than the control group(9.4％ vs.21.9％;12.5％ vs.28.1％;x2 =3.102,3.715;P＜0.05).The SAS, SDS scores in the two groups after treatment were both higher than before, and the control group were significantly higher than the treatment group(t =3.326,3.845;P＜0.05).Conclusion The serious condition of elderly patients with ischemic heart failure are better to ICU, which could greatly improve clinical effect and anxiety depression.