论文部分内容阅读
目的针对老年危重症患者心力衰竭(心衰)的发病特征进行分析,并探讨影响老年危重症患者心衰发病的危险因素。方法 100例老年危重症患者作为研究对象,结合患者的临床表现,分析造成老年危重症患者心衰发病的主要因素。利用回顾性分析对老年危重症患者的临床资料进行细致化分析,主要包括患者的年龄、既往病史(冠心病、肾脏功能不全、肺结核、脑血管阻塞、糖尿病、高血脂、心衰)及相关可能危险因素(吸烟史、饮酒史、大型手术)等。结果本次研究中,患者年龄60~90岁,平均年龄(73.2±4.1)岁。100例患者中,有48例患者合并出现心衰病症,平均年龄(73.2±4.1)岁;其余52例患者未合并出现心衰病症,平均年龄(69.5±3.7)岁;合并出现心衰患者平均年龄大于未合并出现心衰患者,差异具有统计学意义(P<0.05)。在合并出现心衰病症的48例患者中,有40例在2 d之内进行了超声心动图检测,其中,12例患者的左室射血分数(LVEF)<35%,左室收缩功能不全;28例患者左室收缩功能正常。左室收缩功能不全患者平均年龄(68.7±3.4)岁小于左室收缩功能正常患者的(73.5±2.1)岁,差异具有统计学意义(P<0.05)。左室收缩功能不全男性患者所占比例为66.7%,高于左室收缩功能正常男性患者的32.1%,差异具有统计学意义(P<0.05)。经Logistic回归分析,器质性心脏病、糖尿病、肾脏功能不全、大型手术、年龄大、呼吸功能障碍为老年危重症患者心衰发病的独立危险因素(P<0.05)。结论老年危重症患者心衰发病的影响因素有很多种,加强对患者的肾脏功能维护以及规避手术风险,可以起到很好的预防效果。
Objective To analyze the incidence of heart failure (HF) in elderly critically ill patients and to explore the risk factors that affect the incidence of HF in elderly critically ill patients. Methods 100 senile critically ill patients as the research object, combined with the clinical manifestations of patients, analysis of the main causes of heart failure in elderly critically ill patients. Retrospective analysis of the clinical data of elderly critically ill patients with detailed analysis, including the patient’s age, previous medical history (coronary heart disease, renal insufficiency, pulmonary tuberculosis, cerebrovascular obstruction, diabetes, hyperlipidemia, heart failure) and related possible Risk factors (smoking history, alcohol history, major surgery) and so on. Results In this study, patients aged 60 to 90 years, mean age (73.2 ± 4.1) years. Among the 100 patients, 48 patients had heart failure with an average age of (73.2 ± 4.1) years. The remaining 52 patients did not have heart failure with an average age of 69.5 ± 3.7 years. The average number of patients with heart failure The difference was statistically significant (P <0.05). Echocardiography was performed in 40 of the 48 patients with a combined heart failure condition within 2 days, of which 12 had a left ventricular ejection fraction (LVEF) <35% and a left ventricular systolic dysfunction ; 28 patients with normal left ventricular systolic function. The mean age of patients with left ventricular systolic dysfunction (68.7 ± 3.4) years was less than that of patients with normal left ventricular systolic function (73.5 ± 2.1) years, the difference was statistically significant (P <0.05). The percentage of male patients with left ventricular systolic dysfunction was 66.7%, which was higher than that of 32.1% of male patients with normal left ventricular systolic function. The difference was statistically significant (P <0.05). Logistic regression analysis showed that organic heart disease, diabetes mellitus, renal insufficiency, large surgery, older age, and respiratory dysfunction were independent risk factors for heart failure in senile critically ill patients (P <0.05). Conclusion There are many influencing factors for the incidence of heart failure in elderly critically ill patients. It can improve the renal function of patients and avoid the risk of surgery, which can play a good preventive effect.