| ObjectiveTo study the epidemiological characteristics?clinical features and diagnosis and treatment status of acute heart failure(AHF)in our hospital,690 hospitalized cases of acute heart failure range between January 2015 and February 2017 had been analyzed retrospectively,to summarize the current status of diagnosis and treatment of AHF,find out the treatment principles and the evolution of medication,that provide reference for future clinical research and treatment.MethodsThe subject collected the hospitalized cases of AHF in First Affiliated Hospital of Guangzhou University of Chinese Medicine which diagnosed as acute heart failure between January 2015 and February 2017.a total of 690 cases were collected,collecting basic information of patients,laboratory tests and auxiliary tests,the treatment of heart failure and combined disease state,syndrome differentiation and treatment of TCM,outcome of prognosis and drug-taking situation were analyzed.The data were collected and analyzed by SPSS 20.0.The statistical data was used to measure the data.General statistical description and chi-square test,if the statistical P <0.05,suggesting that the difference was statistically significant.Results1.General statistics of cases: 690 cases were collected in this subject,including 395 males and 295 females.The age range of the patients was 18-100 years old,with an average age of 69.72 + 15.287 years,and the statistical significance was statistically significant(P<0.05)for the gender of AHFpatients at all ages.83.77% of the patients in the hospital are cantonese,and the number of hospitalized patients with all kinds of health care reimbursement is 53.04%,and the maximum number of admission to the winter is 35.94%.2.Auxiliary inspection:BNP:the improved rate of patients with different levels of BNP were different(P<0.05).With the increase of the BNP,the improved rate was decreased,and the comparison between groups was statistically significant.Sensitive troponin I:the improved rate of patients with different levels of hsTNI were different(P<0.05).With the increase of hsTNI,the improved rate of the patients decreased,and the comparison between groups was statistically significant.Serum sodium:the improved rate of patients with different levels of serum sodium levels were different(P<0.05),with the lowest rate of concomitant hyponatremia,61.81%.Electrocardiogram(ecg): the first three results of the electrocardiogram(ecg)examination were as follows: st-t ischemic changes(25.07%),atrial fibrillation(22.90%),sinus tachycardia(12.32%).Heart color ultrasound: according to the results of the heart color doppler ultrasound,the number of the three patients were: mitral valve closure(63.19%),aortic valve closure(61.01%),tricuspid valve closure(59.86%),all of which were heart valve lesions.LEVF:the improved rate of patients with different levels of ejection fraction were different(P<0.05),and the comparison between groups was statistically significant.Among them,ejection fraction decreased heart failure rate,the lowest rate was 69.86%.Films: the chest X-ray results according to the statistical number frequency as follows: increase mental image(66.52%),pulmonary infection(44.64%),pleural effusion(35.80%),pulmonary edema(25.07%),emphysema(21.45%).3.Diagnosis and treatment of Chinese and western medicine: statistics suggest that the commonly used western medicine treatment methods in our hospital are as follows: diuresis(93.19%),vascular dilatation(75.22%),positive muscle strength(73.19%),and antithrombosis(67.54%).690 cases of acute heart failure in patients with deficiency syndrome is given priorityto,accounting for 70.6%,among them see clip phlegm,heat,blood stasis and damp turbidity and other empirical.On the basis of syndrome differentiation,treatment was focus on invigorating Yin and Yang,enriching qi and activating blood.4.State treatment of basic diseases:Coronary heart disease(CHD)related treatment: all kinds of drugs in accordance with the use frequency size,the top five was as follows:statin(71.91%),beta blockers(62.54%),ACEI(49.83%),CCB(40.13%),double resistance(36.79%).Anti-infective treatment: all kinds of drugs in accordance with the use frequency size,the top three was as follows: cefalosporins and other beta-lactam antibiotics(90.13%),quinolone antibiotics(32.40%),and antifungal drugs(6.89%).Anti-arrhythmic drug use: all kinds of anti-arrhythmic drugs and treatment according to the use frequency,the top three in the order: extend the action potential in medicine(70.75%),beta blockers(17.92%),electrical shock(6.60%).Regulation of blood glucose therapy: all kinds of hypoglycemic drugs were listed as follows: insulin(73.70%),alpha-glucoside inhibitor(30.00%)and sulfonylureas(20.74%).Antihypertensive treatment: the three kinds of antihypertensive drugs according to using frequency size arrangement is as follows: beta blockers(59.03%),(ii)hydrogen pyridine class calcium antagonists(57.87%),ACEI drugs(53.47%).Anemia related treatment: all kinds of anemia treatment are arranged according to use frequency: erythrin(53.85%),iron(58.24%),blood transfusion(51.10%).5.Prognosis and rehospitalization rate: Among 690 hospitalized cases,the rate was 67.25%,the mortality rate was 14.35%,the rehospitalization rate was 26.23%,and the rehospitalization rate was 11.88% within half a year.In the hospital,83 cases were discharged due to the patient's reasons,accounting for 12.03%,and 30 cases were discharged from the hospital,accounting for4.35 percent,and 14 cases in the hospital,accounting for 2.03 percent.Conclusion:Acute heart failure is a common clinical critical illness,often in winter.As the age of the patient increased,the incidence of AHF was also on the rise,and the incidence of AHF was higher among male patients in each age group than in female patients.Acute heart failure diagnosis,need combined with symptoms,signs,laboratory examination,auxiliary examination to evaluate,among them,the BNP,allergic troponin,serum sodium is one of the important laboratory prognosis assessment indicators.The prognosis is worse when the presence of BNP or hypertrophic troponin increases,or when hyponatremia is combined.In the aspect of auxiliary examination,electrocardiogram,heart color ultrasound and chest film provide the significance of AHF etiology,and EF is of great value in evaluating the prognosis of the disease.In the treatment,the commonly used western medicine treatment method is diuretic,blood vessel dilation,positive muscle strength,non-drug treatment proportion is elatively low.In the diagnosis and treatment of traditional Chinese medicine,the patients with acute heart failure in our hospital are mainly suffering from the deficiency syndrome,among which,the evidence of blood stasis,water stopping and phlegm-dampness is found.Traditional Chinese medicine therapy is mainly used to supplement Yin and Yang,invigorate qi and invigorate blood and blood,and the use of Chinese medicine is mainly intravenous administration,which is in line with the characteristics of disease.Among 690 patients with AHF,the rate was 66.38%,and the mortality rate was 14.64%,suggesting that it was one of the clinical syndromes with high clinical mortality. |
PDF Full Text Request