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目的探讨慢性收缩性心力衰竭(心衰)的规范治疗。方法对198例慢性心衰患者,根据临床情况,在一般治疗的基础上应用药物治疗。观察其心功能改善情况。结果明显改善52例,占26.26%;好转128例,占64.65%;未愈6例,占3.03%;恶化2例,占1.01%;死亡10例,占5.05%。死亡原因:泵衰竭7例(70%),猝死2例(20%),心律失常1例(10%)。结论慢性收缩性心衰的规范治疗应强化神经内分泌拮抗剂的合理应用,强调改善左室重塑治疗的获益(降低死亡率、病残率和住院率);合理应用利尿剂及硝酸酯类药物,正确选择洋地黄类正性肌力药物,慎用非洋进黄类正性肌力药物以缓解症状;严格掌握抗心律失常药物应用指征;正确选择其他药物(钙拮抗剂、抗凝剂等),合理进行氧疗,并重视心衰基本病因的防治及心衰诱因的纠正。
Objective To investigate the standard treatment of chronic systolic heart failure (HF). Methods 198 patients with chronic heart failure, according to the clinical situation, the general treatment based on the application of drug treatment. Observe the improvement of cardiac function. Results improved significantly in 52 cases, accounting for 26.26%; 128 cases improved, accounting for 64.65%; 6 cases unhealed, accounting for 3.03%; 2 cases of deterioration, accounting for 1.01%; 10 cases died, accounting for 5.05%. Causes of death: pump failure in 7 cases (70%), sudden death in 2 cases (20%), arrhythmia in 1 case (10%). Conclusion The standard treatment of chronic systolic heart failure should strengthen the rational use of neuroendocrine antagonists, emphasizing the benefit of improving left ventricular remodeling (reducing mortality, morbidity and hospitalization rate); rational use of diuretics and nitrates Drugs, the correct choice of digitalis positive inotropic drugs, caution non-Western into the yellow type of inotropic drugs to relieve symptoms; strict anti-arrhythmic drug indications; the correct choice of other drugs (calcium antagonists, anticoagulants Agents, etc.), reasonable oxygen therapy, and emphasis on the prevention and treatment of the basic causes of heart failure and correction of heart failure incentives.