RESUMO
Objective To investigate early nasogastric nutrition on patients with acute decompensated chronic heart failure,and observe its influence on patient's disease outcome.Methods From January 2012 to December 2013,100 cases with acute decompensated chronic heart failure were used as the research subjects,were randomly divided into experimental and control groups with 50 cases each group.Patients of two groups adopt expansion of blood vessels,strong heart,diuresis,and routine anti-infection treatment;Based on this scheme,experimental group adopt early nasogastric nutrition.The cardiac function index,the change of nutritional status and clinical curative effect and the result of follow-up within 1 year after discharge of two groups were compared.Results Left ventricular end-diastolic dimension (LVEDD) and left ventricular end-systolic dimension (LVESD) in two groups after treatment were decreased,and the descender of experimental group was superior to that of the control group with statistically significant difference (P ＜ 0.05).After treatment,left ventricular ejection fractions (LVEF) of two groups were improved,and the rise of experimental group was superior to that of control group with statistically significant difference (P ＜0.05).In the two groups after treatment,the serum brain natriuretic peptide (BNP) levels were significantly decreased,and the descender of the experimental group was more than that of control group with statistically significant difference (P ＜ 0.05).After treatment,body mass index (BMI),the level of serum prealbumin (PA),transferrin (TRF),and the total number of lymphocytes of two groups were increased significantly (P ＜ 0.05);and BMI,the level of serum PA and TRF,and the total number of lymphocytes of the experimental group were significantly better than those of the control group (P ＜ 0.05).The total effective rate of the experimental group was significantly higher than that of the control group (P ＜ 0.05).The exacerbation rates,readmission and mortality rate of experimental group follow-up within 1 year after discharge were significantly lower than that of the control group (P ＜ 0.05).Conclusions The early nasogastric nutrition on the patients with acute decompensated chronic heart failure was better able to improve patients' nutrition state,more conducive to patients with cardiac function recovery,improve the clinical curative effect,and reduce the exacerbation rates,and readmission and mortality rate.
RESUMO
Objective To investigate the relationship between different left ventricular pacing sites and clinical benefit in heart failure patients treated with cardiac resynchronization therapy (CRT).Methods Clinical data of 52 patients of CRT-P/D (pacing and defibrillation) implantation were collected.According to the left ventricular lead implantation sites,52 cases were divided into anterior wall (10 cases),lateral wall (15 cases),posterior wall (16 cases),and posterior base group (11 cases).The efficacy of CRT was evaluated by Minnesota life quality score,left ventricular function and remodeling index.Results In addition to the anterior wall group,Minnesota life quality score of the other groups were significantly lower than preoperative group (P ＜ 0.05).Compared to pre-CRT implantation,left ventricular end diastolic diameter (LVEDD) of the anterior wall and posterior basal group 3 months after CRT implantation had no statistical significance (P ＞ 0.05);the rest groups were lower than preoperative group (P ＜ 0.05).Left ventricular ejection fraction (LVEF) in posterior wall group was increased after CRT implantation 3 months compared to the preoperative group (P ＜0.05).LVEF in anterior wall group was increased only in the 12 months after CRT implantation (P ＜ 0.05).LVEF in the rest groups was increased comparing to the preoperation at 6 and 12 months postoperation (P ＜0.05).CRT non-response rate in anterior wall group was significantly higher than that in the other groups (P ＜ 0.05).CRT response ratio was significantly increased in side,posterior and posterior basal wall compared to the anterior Wall group (P ＜ 0.05).And there were no statistical significance among side wall,posterior wall and basal wall group (P ＞ 0.05).△ QRSd was higher in side wall,posterior wall and posterior basal group after CRT implantation 3 months than anterior wall group (P ＜ 0.05),△ QRSd in posterior basal group was lower than the other two groups (P ＜0.05).Conclusions Left ventricular electrode should be implanted at the side wall and posterior wall firstly,secondly at the posterior basal wall,and avoid at the anterior wall of the left ventricle.