【作者】 李春雨； 姜婷； 王魏魏； 陈君； 何琪芳； 张劲松； 齐炼文； 李萍； 曹克将； 陈彦；

【Author】 Chunyu Li;Ting Jiang;Weiwei Wang;Jun Chen;Jinsong Zhang;Lian-wen Qi;Ping Li;Kejiang Cao;Yan Chen;Emergency Center,the First Affiliated Hospital of Nanjing Medical University;

【机构】 南京医科大学第一附属医院急诊中心； 中国药科大学； 南京医科大学第一附属医院心脏科； 江苏省妇幼保健院医务处；

【摘要】 目的:了解江苏省人民医院急诊抢救室心力衰竭患者病因分布特点及治疗现状。方法回顾性调查和分析江苏省人民医院急诊抢救室2011-2013年收治的心力衰竭患者,对其病因分布及治疗现状进行统计学分析。结果:共有1190例心力衰竭患者入选,占同期所有病例的11.20%。其中男性768例(64.54%),平均年龄(63.33±14.68)岁;女性422例(35.46%),平均年龄(59.97±16.85)岁。急诊抢救室心力衰竭常见病因主要有:高血压(27.23%)、冠心病(25.38%)、肺心病(18.74%)、尿毒症(9.66%)、老年性心瓣膜病(6.64%)等。不同病因心衰年龄分布有差异(P<0.01),且以高血压、冠心病、肺心病和老年性瓣膜病为病因的心衰患者呈现老年化,以心肌病、心包积液、风心病和先心病为病因的心衰患者呈现年轻化。除风心病所致心衰外,其余所有不同病因心衰患者,男性患者的患病率均高于女性,平均是女性患者的1.82倍,其中心肌病、冠心病和尿毒症所致心衰患者中男性患者分别是女性患者的4.14、3.72、2.19倍。急诊抢救室心力衰竭的治疗以利尿、扩血管、强心、醛固酮受体拮抗剂为主,主要技能有血液透析脱水、呼吸机辅助通气等。结论:江苏省人民医院急诊抢救室心力衰竭患者所占比例较高,男性发病率高,主要病因是高血压、冠心病和肺心病等,不同病因心衰年龄分布也有差异。治疗除了常规药物治疗,还应根据病情需要,使用呼吸机辅助正压通气和血液净化脱水等非药物治疗途径。更多还原

【Abstract】 Objective To investigate the etiological factors and condition of treatment of heart failure in emergency department of Jiangsu Provincial hospit al.Methods To retrospectively investigate and analysis the heart failure patient s in emergency department of Jiangsu Provincial hospital from 2011-2013 and make a statistical analysis of etiological distribution and condition of therapy.Results A total of 1190 patients diagnosed with heart failure enrolled the study,making up 11.20%of all cases.Among them:male 768(76.54%),average age were 63.33±14.68;female 422(35.46%),average age were 59.97±16.85;Commo n causes of heart failure in emergency department include:hypertension(27.23%),coronary heart disease(25.38%),pulmonary heart disease(18.74%),uremia(9.66%),senile valvular disease(6.64%),cardiomyopathy(6.05%),pericardial effus ion(3.02%),rheumatic heart disease(2.69%).et al.Different causes led to significan t differences(P<0.05).Patients with hypertension,coronary heart disease,pulmon ary heart disease and senile valvular disease show a trend of aging,whereas p atients with cardiomyopathy,pericardial effusion,rheumatic heart disease and c ongenital heart disease are shown more in younger ones.Among all causes,th e prevalence of male are larger than female patients other than rheumatic heart disease and the average male incidence of women are 1.82 times,specifically,the male prevalence of woman in cardiomyopathy 、 coronary heart disease and uremia are 4.14、3.72 and 2.19 times.Drug treatment for heart failure includes dieresis,vasodilator,cardiotonic and aldosterone receptor antagonist,and for serio us patients,we also add the hemodialysis and mechanical ventilation.Conclusio ns Common causes of heart failure in emergency department include:hypertens ion,coronary heart disease and pulmonary heart disease et al.Age distribution is different among different causes.Heart failure accounts for larger in emergen cy department and male prevalence is even higher.In addition to regular drug therapy,hemodialysis and mechanical ventilation are also important when necess ary.更多还原