我院心源性肺水肿临床现状及预后分析

Analysis of the Clinical Status and Prognosis of Cardiogenic Pulmonary Edema in Our Hospital

目的:探讨我院急性心源性肺水肿的临床现状及预后的影响因素,为吗啡的合理应用提供依据。方法:选取急性心源性肺水肿患者105名,收集患者的临床资料,并记录患者的转归,获取影响患者预后的指标及明确吗啡应用对预后的影响。结果:本组患者住院期间病死率高达28.5%,对预后有影响的因素主要包括急性冠脉综合征导致的急性肺水肿、慢性心力衰竭急性发作、B型脑利钠肽水平、插管与否、病史中应用β受体阻滞剂;应用吗啡增加气管插管的发生率,但未发现与患者病死率有统计学相关。结论:在确诊的心源性肺水肿患者吗啡应用也会增加气管插管的比率,无条件行机械通气的心源性肺水肿患者抢救中慎重应用吗啡。

Objective：To explore the clinical status and influencing factors on prognosis of acute cardiogenic pulmonary edema in our hospital,and to provide the basis for rational use of morphine.Methods：Clinical data of 105 patients with acute cardiogenic pulmonary edema were collected,and the outcome was recorded.Indexes that influencing patient＇s prognosis and effects of morphine on prognosis were defined.Results：The hospital mortality was 28.5%.The influencing factors on prognosis included acute coronary syndrome induced acute pulmonary edema,acute attack of chronic heart failure,level of B-type natriuretic peptide,intubation or not and history of taking beta-blockers.Application of morphine might increase the frequency of tracheal intubation,but not statistically correlated with patient＇s mortality.Conclusions：Morphine can increase the rate of mechanical ventilation even when used in confirmed acute cardiogenic pulmonary edema.Morphine should be used carefully especially when mechanical ventilator is not available.