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目的分析老年重症心力衰竭急诊内科治疗的临床效果与影响因素。方法 2015年1月~2016年8月,医院急诊内科处置老年重症心力衰竭42例,安排体位管理、基础用药,控制心律失常,病因治疗,吸氧治疗。结果出急诊科,患者尿量、血钾、血钠、SBP、HR、RR、APACHEⅡ评分低于入院时,出急诊科PaO_2/FiO_2、CO、E/A高于入院时,差异有统计学意义(P<0.05)。并发休克8例、心律失常11例、死亡4例,合计23例。病例组低钾血症、低血压、低氧血症、药物不耐受发生率高于对照组,差异有统计学意义(P<0.05)。结论老年重症心力衰竭急诊内科治疗整体疗效有待提高,应及时发现药物不耐受,调整用药策略。
Objective To analyze the clinical effects and influential factors of emergency medical treatment for elderly patients with severe heart failure. Methods From January 2015 to August 2016, 42 cases of severe elderly patients with severe heart failure were treated in emergency department of the hospital. Position management, basic medication, arrhythmia control, etiological treatment and oxygen therapy were arranged. The results of the emergency department, the patient urine output, serum potassium, serum sodium, SBP, HR, RR, APACHE Ⅱ score was lower than admission, the emergency department PaO_2 / FiO_2, CO, E / A higher than admission, the difference was statistically significant (P <0.05). Complicated shock in 8 cases, arrhythmia in 11 cases, 4 patients died, a total of 23 cases. Cases of hypokalemia, hypotension, hypoxemia, drug intolerance incidence was higher than the control group, the difference was statistically significant (P <0.05). Conclusion The overall efficacy of emergency medical treatment of elderly patients with severe heart failure needs to be improved. Drug intolerance should be found in time to adjust the medication strategy.