张耀辉 姚晓丽

[摘要] 目的 探討集束化治疗急诊急性心力衰竭的临床疗效。 方法 选择2018年1～12月在医院急诊诊治的急性心力衰竭患者100例患者的临床资料进行回顾性分析。其中50例患者采用传统急救治疗为对照组，50例患者采用集束化治疗为观察组。比较治疗前及治疗72 h后两组患者心率、收缩压、血氧饱和度、呼吸、平均动脉压、NYHA心功能分级、24 h尿量。比较治疗前及治疗72 h后患者LVEF及LVEDD。统计患者气短缓解时间，住院时间及气管插管率。 结果 （1）治疗后，两组心率、收缩压、平均动脉压、呼吸频率均较治疗前显著下降，差异有统计学意义（P<0.05）;治疗后，观察组心率、收缩压、平均动脉压、呼吸频率显著低于对照组，差异有统计学意义（P<0.05）。治疗后，两组血氧饱和度、24 h尿量均显著高于治疗前，差异有统计学意义（P<0.05）;治疗后，观察组血氧饱和度、24 h尿量均显著高于对照组，差异有统计学意义（P<0.05）。（2）治疗后两组LVEF均较治疗前显著提高，差异有统计学意义（P<0.05）;治疗后，观察组LVEF水平显著高于对照组，差异有统计学意义（P<0.05）。（3）观察组气短缓解时间及住院时间显著低于对照组，差异有统计学意义（P<0.05）;气管插管率显著低于对照组，差异有统计学意义（P<0.05）。结论 集束化治疗急诊急性心力衰竭可快速缓解症状，改善心率、血压等相关指标，降低气管插管率。

[关键词] 集束化治疗;急诊;急性心力衰竭;心率;收缩压;平均动脉压;血氧饱和度

[中图分类号] R541.6          [文献标识码] B          [文章编号] 1673-9701（2020）15-0112-04

Clinical effect of clustering treatment on emergency acute heart failure

ZHANG Yaohui   YAO Xiaoli

Emergency Department， Huzhou Central Hospital in Zhejiang Province， Huzhou   313000， China

[Abstract] Objective To investigate the clinical effect of clustering treatment on acute heart failure in emergency department. Methods The clinical data of 100 patients with acute heart failure who were diagnosed and treated in the emergency department in the hospital from January to December 2018 were retrospectively analyzed. 50 patients were given traditional first aid as the control group. 50 patients were given clustering treatment as the observation group. Heart rate， systolic blood pressure， blood oxygen saturation， respiration， mean arterial pressure， NYHA cardiac function grade， and 24 h urine volume before treatment and 72 h after treatment were compared between the two groups of patients. The LVEF and LVEDD before treatment and 72 h after treatment were compared. The short breath remission time， length of hospital stay and tracheal intubation rate were statistically analyzed. Results （1）After treatment， the heart rate， systolic blood pressure， mean arterial pressure， and respiratory rate in both groups were significantly lower than those before treatment，and the differences were statistically significant（P<0.05）; after treatment，the heart rate， systolic blood pressure， mean arterial pressure， and respiratory rate in the observation group were significantly lower than those in the control group， and the differences were statistically significant（P<0.05）. After treatment， blood oxygen saturation and 24 h urine volume in both groups were significantly higher than those before treatment， and the differences were statistically significant（P<0.05）; After treatment， blood oxygen saturation and 24 h urine volume in the observation group were significantly higher than those in the control group， and the differences were statistically significant（P<0.05）. （2）After treatment， LVEF in both groups was significantly higher than that before treatment， and the difference was statistically significant（P<0.05）; after treatment， the LVEF level in the observation group was significantly higher than that in the control group， and the difference was statistically significant（P<0.05）.（3）The short breath remission time in the observation group was significantly shorter than that in the control group， and the difference was statistically significant（P<0.05）; the tracheal intubation rate and hospital stay significantly shorter than that in the control group， and the difference was statistically significant（P<0.05）. Conclusion Clustering treatment for emergency acute heart failure can quickly relieve symptoms， improve heart rate， blood pressure and other related indicators， and reduce tracheal intubation rate.

[Key words] Clustering treatment; Emergency; Acute heart failure; Heart rate; Systolic pressure; Mean arterial pressure; Blood oxygen saturation

急性心力衰竭是临床最重要的心血管疾病和心脏病，呈全球性流行态势，在不同国家人群中的患病率约为11 000～19 000/100万[1]。欧美的流行病学调查资料显示，65岁以下男性和女性的心衰年发病率分别为0.10%和0.04%，而65岁以上者则跃升至为1.10%和0.50%[2]。集束化治疗是集合一系列有循证基础的治疗及护理措施处理疾病的过程，目的是帮助医务人员为患者提供优化的治疗及护理措施[3]。集束化治疗可在同一环境、相关时间内实施，有明确的实践性、目标性及序贯性[5，6]。本文将集束化治疗用于急诊急性心力衰竭患者的治疗中，探讨其应用效果，以期为临床诊断治疗提供参考，现报道如下。

1 资料与方法

1.1 一般资料

选择2018年1～12月在本院急诊诊治的急性心力衰竭患者100例患者的临床资料进行回顾性分析。……