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目的总结老年维持性血液透析(MHD)患者心血管急症的特点及防治体会。方法回顾性分析我院老年病房1996年12月至2007年3月诊治的12例老年 MHD 患者心血管急症的临床资料。结果共发生各种心血管急症63例次。其中急性冠脉综合征(ACS)18例次(不稳定性心绞痛16例次,急性 ST 段抬高心肌梗死2例次),急性左心衰竭17例次,严重低血压13例次,心律失常7例次,高血压急症4例次,脑出血2例次,心跳骤停2例次。心血管急症导致死亡4例,其中2例为脑出血,1例为急性左心衰竭合并重症肺部感染,1例因心跳骤停而猝死。结论老年 MHD 患者心血管急症造成的病死率高,应及时诊断,正确处理,加强预防。
Objective To summarize the characteristics and prevention and treatment of cardiovascular emergencies in elderly patients with maintenance hemodialysis (MHD). Methods The clinical data of 12 elderly MHD patients with cardiovascular emergencies diagnosed and treated in our old ward from December 1996 to March 2007 were retrospectively analyzed. Results A total of 63 cases of various cardiovascular emergencies. Among them, 18 were acute coronary syndrome (ACS), 18 cases were unstable angina pectoris, 2 cases were acute ST-segment elevation myocardial infarction, 17 cases were acute left heart failure, 13 cases were severe hypotension, arrhythmia 7 cases, 4 cases of emergency, 4 cases of intracerebral hemorrhage, 2 cases of cardiac arrest, 2 cases of cardiac arrest. Cardiovascular emergencies led to death in 4 cases, of which 2 cases of cerebral hemorrhage, 1 case of acute left heart failure with severe pulmonary infection, 1 case of sudden cardiac arrest due to sudden death. Conclusions Cardiovascular emergencies in elderly patients with MHD caused high mortality rate, which should be promptly diagnosed, correctly treated and strengthened in prevention.