急诊内科危重症心力衰竭患者合并肺部感染的危险因素分析

摘要

目的 研究急诊内科危重症心力衰竭患者合并肺部感染的相关危险因素分析.方法 选取2013年11月-2016年11月经我院急诊内科收治的危重症心力衰竭患者82例,依据肺部感染情况分为肺部感染组40例和非肺部感染组42例,对比两组患者的临床基本资料,研究心力衰竭患者的糖尿病、LVEF、CRP、慢阻肺、侵入性操作、高血压疾病等影响因素与并发肺部感染的相关性,并对心力衰竭患者并发肺部感染的预防措施进行总结.结果 肺部感染组患者年龄≥80岁,在C反应蛋白(CRP)、糖尿病、高血压、吸烟史、慢性阻塞性肺疾病(慢阻肺)、住院时间等所占比例均高于非肺部感染组,LVEF左心室射血分数≥55%的患者占比显著低于非肺部感染者(P<0.05);对比两组患者有无侵入性操作,差异无统计学意义(P>0.05).多因素Logistic回归分析显示,住院时间与糖尿病是导致老年心力衰竭并发肺部感染的主要危险因素(P<0.05).结论 老年心理衰竭患者并发肺部感染的主要影响有糖尿病、慢阻肺、住院时间,而CRP升高与肺部感染相关,针对上述因素制定有效的预防措施,降低老年心力衰竭患者发生肺部感染率.%Objective Objective To study the risk factors associated with pulmonary infection in critically ill patients with heart failure in emergency internal medicine. Methods From November 2013 to 2016 in the emergency internal medicine department of our hospital,82 critically ill patients with heart failure were divided into the lung in-fection group (n=40) and the non lung infection group(n=42) based on the situation of lung infection. The clini-cal data of heart failure,diabetes,LVEF,CRP,COPD,intrusion correlation effect of operation,and factors such as hypertension disease complicated with pulmonary infection,and heart failure patients complicated with pulmonary in-fection prevention measures were summarized and analyzed. Results CRP,diabetes, hypertension, smoking histo-ry,chronic obstructive pulmonary disease (COPD),and total hospitalization time were higher in the infection group than in the non pulmonary infection group. The proportion of LVEF left ventricular ejection fraction more than 55%was significantly lower in the lung infection group than in the non pulmonary infection group(P<0.05). There was no significant difference in invasive operation between the two groups (P>0.05). Multivariate logistic regression a-nalysis showed that hospitalization time and diabetes were the major risk factors for elderly heart failure complicated with pulmonary infection(P<0.05). Conclusion The main effect of elderly heart failure patients complicated with pulmonary infection includes diabetes, COPD, and hospitalization time. The increased CRP is associated with lung infection. It needs effective preventive measures according to the above factors to reduce the incidence of pulmonary infection in elderly patients with congestive heart failure.