慢性肺心病60例死因临床分析

CLINICAL ANALYSIS OF DEATH CAUSE OF SIXTY CASES OF CHRONIC CARDIOPULMONARY DISEASE

目的:分析慢性肺心病的死亡原因及相关危险因素。方法:将我院1998年1月至2008年1月收治的428例慢性肺心病的60例死亡病例的临床资料进行回顾性分析。结果:①60例死亡的患者平均年龄65.4岁,远远低于我国人口平均预期寿命(71.4岁);②原发病以COPD为主,确诊为肺心病到死亡时间10年以下者36例(60%),坚持家庭氧疗、接种流感疫苗能延长患者寿命;③本组患者3个以上脏器受损者45例(75%),所有病例均有并发症发生,首位为肺部感染者60例(100%),其次为酸碱平衡失调、水电解质紊乱、肺性脑病、营养不良等。死因肺性脑病排在首位,其次为心力衰竭、上消化道出血等。结论:慢性肺心病死亡主要与呼吸道感染、呼吸衰竭、多器官功能损害及营养不良有关。

Objective：To analyze the death cause and correlated risk factors of chronic cardiopulmonary disease.Methods：Retrospective analysis of clinical data of sixty death cases from four hundred and twenty-eight chronic cardiopulmonary disease cases in our hospital from January, 1998 to January, 2008 was made. Results： （1）The mean age of 60 dead cases was 65.4 years, much lower than the Chinese average life expectancy （71.4）. （2） The primary disease of these 60 dead cases was chronic obstructive pulmonary disease （COPD）, and the survival time（St）after diagnosis confirmed was within 10 years in 36 cases（60%）.Continual home oxygen therapy and innoculation of influenza vaccine can improve their survival time. （3） The cases beyond three impaired organs were 45 （75%）. Complications could be observed among all the cases, and major complication was pulmonary infection（60 cases,100%） ,minor complications were acid-base imbalance, electrolyte disturbances, pulmonary encephalopathy and dystrophia. The major cause of death was pulmonary encephalopathy, and minor cause was heart failure（HF） and upper gastrointestinal hemorrhage. Conclusion：The death cause of chronic cardiopulmonary disease is mainly concerned with respiratory tract infection, respiratory failure, multi-organ functional lesion and dystrophia.