Stalman W A B
VU Medisch Centrum, afd. Huisartsgeneeskunde, Van der Boechorst-straat 7, 1008 BT Amsterdam.
Ned Tijdschr Geneeskd. 2005 Nov 26;149(48):2653-4.
The practice guideline 'Heart failure' from the Dutch College of General Practitioners will be a source of support for the general practitioner/family physician. Its clear set of diagnostic steps helps the general practitioner to assess heart failure in patients with breathlessness, fatigue, decreased exercise tolerance or ankle swelling. Testing plasma concentrations of natriuretic peptides plays a new and central diagnostic role. This guideline differs from the previous one in another important aspect. Based on many RCT's and reviews the authors have succeeded in developing a detailed but balanced treatment protocol for heart-failure patients in general practice. However, adverse effects from co- and multi-medication in the growing number of frail elderly may reduce the patients' compliance.
荷兰全科医生学院的“心力衰竭”实践指南将为全科医生/家庭医生提供支持。其清晰的诊断步骤有助于全科医生评估出现呼吸急促、疲劳、运动耐量下降或脚踝肿胀的患者是否患有心力衰竭。检测利钠肽的血浆浓度发挥着新的核心诊断作用。该指南在另一个重要方面与先前的指南有所不同。基于众多随机对照试验和综述,作者成功为全科医疗中的心力衰竭患者制定了一份详细但平衡的治疗方案。然而,在越来越多的体弱老年人中,联合用药和多种药物治疗带来的不良反应可能会降低患者的依从性。