老年急性心肌梗死患者并发肺部感染的危险因素分析及护理对策

目的探讨老年急性心肌梗死(AMI)患者并发肺部感染的危险因素及护理对策。方法回顾性分析我院心内科2012年1月~2015年1月收治的老年AMI患者160例的临床资料,根据患者有无并发肺部感染分为感染组(观察组,n=36)和非感染组(对照组,n=124),比较两组患者的性别、年龄、吸烟史、左室射血分数(LVEF)、基础疾病等变量,研究上述变量与肺部感染的相关性,进一步分析AMI患者并发肺部感染的独立危险因素,比较两组患者住院时间和死亡率。结果观察组在年龄、合并糖尿病、吸烟等变量较对照组明显升高,LVEF值较对照组明显下降,差异均有统计学意义(P0.05)。将这些变量纳入多元Logistic回归分析显示,年龄、低EF水平及合并糖尿病是老年AMI患者合并肺部感染的独立危险因素。观察组住院时间为(24.5±2.6)天明显长于对照组的(18.2±3.8)天,病死率为25%明显高于对照组的15.2%,差异均有统计学意义(均P0.05)。结论高龄、低LVEF、合并糖尿病是老年AMI患者并发肺部感染的独立危险因素,对合并上述危险因素患者应实施针对性的护理措施,从而降低老年心梗的病死率。

Risk Factor Analysis of Pulmonary Infection in Elderly Patients with Acute Myocardial Infarction and Nursing Strategy

Objective To analyze the risk factors of pulmonary infection in elderly patients with acute myocardial infarction (AMI) and nursing management to prevent the infection . Methods Retrospective analysis of 160 ca‐ses of hospitalized elderly patients with AMI in Cardiology Department ,Fujian Provincial Geriatric from January 2012 to January 2015 were enrolled in the present study .All the patients were classified as infected group (observa‐tion group ,n=36) or non‐infected groups (control group ,n=124) based on the presence of pulmonary infection or not .Comparisons were conducted between the two groups on sex ,age ,smoking ,the left ventricular ejection fraction (LVEF) ,basic diseases .The relationships between the above‐mentioned parameters and pulmonary infection were analyzed .The independent risk factors for pulmonary infection were summarized .Mortality and the hospitalization time of the two groups were compared . Results Observation group had a higher incidence of old age ,diabetes , smoking and a lower LVEF than that of observation group ,and the difference was statistically significant (P<0.05) .All the above risk factors were analyzed by stepwise multiple logistic regression analysis .The results showed that old age ,ower EF and diabetes mellitus were independence risk factors of pulmonary infection in elderly patients with AMI .Observation group had a longer hospital stay and higher mortality rates than that of observation group(P<0.05) . Conclusion Old age ,lower LVEF and diabetes mellitus were independence risk factors of pul‐monary infection in elderly patients with AMI .Corresponding nursing procedure for pulmonary infection in elderly patients with AMI should be taken to reduce mortality .