老年人不典型心力衰竭诊治体会.docVIP

老年人不典型心力衰竭诊治体会 　　[摘要] 目的 通过对老年不典型心力衰竭患者的临床资料分析，总结讨论老年不典型心力衰竭的特点、容易误诊的原因和个人治疗的体会。 方法 回顾性分析38例老年不典型心力衰竭的临床资料，对本组病例的基础疾病、临床表现、主要辅助检查、典型病例和治疗结果等临床情况进行了探讨分析。 结果 部分老年心力衰竭患者临床表现不典型，感染尤其是呼吸道炎症仍是老年心力衰竭的主要诱因，老年患者不典型心力衰竭复杂、多变和隐蔽。 结论 对老年不典型心力衰竭患者的治疗，要全面认真，抓住主要矛盾，制定个体化、多学科的综合治疗方案。 　　[关键词] 不典型心力衰竭；老年人；综合诊断治疗 　　[中图分类号] R541.61 [文献标识码] B [文章编号] 2095-0616（2015）06-162-03 　　Experience of diagnosis and treatment of atypical heart failure in aged patients 　　YU Zenian MA Cuirong LIN Lu 　　Department of Emergency，TCM Hospital of Weihai，Weihai 264200，China 　　[Abstract] Objective Through the analysis of the data of aged patients with atypical heart failure，to summarize and discuss the characteristics of aged patients with atypical heart failure，the cause of easy misdiagnosis and the experience of personal therapy. Methods 38 cases of aged patients with atypical heart failure who were selected to study and analyze on the underlying diseases，the clinical manifestation，the main auxiliary examination，the typical cases and the treatment outcome and other clinical conditions. Results Some of the clinical manifestations of aged patients with heart failure whose inducement were still infection especially respiratory inflammation were atypical.Atypical heart failure in aged patients were complex，multivariate，cryptic. Conclusion To grasp the principal contradiction and to make individualized，multidisciplinary and comprehensive treatment protocols in order to treat the aged patients with atypical heart failure comprehensively and seriously. 　　[Key words] Atypical heart failure；Aged；Comprehensive diagnosis and treatment 　　由于老年人自身身体情况的特点，他们一旦患有心力衰竭，常常其临床表现复杂而不典型，也常造成误诊漏诊，从而延误诊断治疗甚至危及生命[1-2]。现就近年来临床所见老年人不典型心力衰竭的诊治体会与大家共享。 　　1 资料与方法 　　1.1 一般资料 　　2009年3月～2014年7月我科共诊治老年不典型心力衰竭38例。男24例，女14例，年龄61～88岁，平均71.5岁。主要基础疾病：冠心病21例，慢性阻塞性肺病（COPD）12例，高血压16例，糖尿病9例，脑梗塞后遗症4例，帕金森综合征2例，老年性痴呆2例，扩张性心肌病2例，有慢性肾功能不全病2例。本组患者患有1种基础疾病者4例，患有2种基础疾病者8例，患有3种基础疾病者11例， 患有4种以上基础疾病者29例。 　　1.2 临床表现及主要辅助检查 　　大部分病例均有咳嗽、咳痰、气促为主要症状，