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目的急诊内科综合干预方案治疗老年重症心力衰竭患者的临床效果。方法选取玉林市第二人民医院2013年10月—2015年10月收治的老年重症心力衰竭疾病患者92例,随机分为对照组和治疗组,各46例。对照组患者采用常规急诊内科干预方案治疗,治疗组患者在对照组基础上给予厄贝沙坦氢氯噻嗪片+美托洛尔口服,并给予急诊内科综合干预。比较两组患者的临床疗效,治疗前后心功能指标(左心室射血分数、脑钠肽)及心功能指标恢复正常时间、心电图检查结果恢复正常时间、临床治疗总时间,并观察比较两组患者治疗期间不良反应发生情况。结果治疗组患者临床疗效优于对照组(P<0.05)。治疗前,两组患者左心室射血分数、脑钠肽比较,差异无统计学意义(P>0.05);治疗后,治疗组患者左心室射血分数高于对照组,脑钠肽低于对照组(P<0.05)。治疗组患者心功能指标恢复时间、心电图检查结果恢复正常时间、临床治疗总时间短于对照组(P<0.05)。治疗组不良反应发生率低于对照组(P<0.05)。结论急诊内科综合干预方案治疗老年重症心力衰竭患者的临床疗效确切,可有效改善患者心功能指标,促进疾病康复,且安全性高。
Objective To evaluate the clinical effect of comprehensive intervention in emergency department in the treatment of elderly patients with severe heart failure. Methods Totally 92 elderly patients with severe heart failure who were admitted to Yulin Second People’s Hospital from October 2013 to October 2015 were randomly divided into control group and treatment group, with 46 cases in each group. Patients in the control group were treated with routine emergency medical intervention. Patients in the treatment group were given oral irbesartan hydrochlorothiazide tablets and metoprolol on the basis of the control group, and were given comprehensive medical and emergency interventions. The clinical efficacy of the two groups were compared. The cardiac function indexes (left ventricular ejection fraction, brain natriuretic peptide) and the indexes of cardiac function returned to normal before and after treatment, the electrocardiogram returned to normal time and the total time of clinical treatment. Adverse reactions during treatment occurred. Results The clinical efficacy of the treatment group was better than that of the control group (P <0.05). Before treatment, left ventricular ejection fraction and brain natriuretic peptide in the two groups had no significant difference (P> 0.05). After treatment, the left ventricular ejection fraction in the treatment group was higher than that in the control group, Group (P <0.05). The recovery time of cardiac function index, the normal time of electrocardiogram examination returned to normal in treatment group were shorter than those in control group (P <0.05). The incidence of adverse reactions in the treatment group was lower than that in the control group (P <0.05). Conclusion The comprehensive clinical intervention program of emergency treatment of elderly patients with severe heart failure has definite clinical curative effect, which can effectively improve the cardiac function indexes of patients and promote the rehabilitation of the disease with high safety.