老年急性心肌梗死患者肺部感染的临床分析

Clinical analysis on pulmonary infection in patients with acute myocardial infarction

目的分析老年急性心肌梗死患者合并肺部感染的临床特点,总结老年急性心肌梗死患者发生肺部感染的高危因素,探讨临床护理对策,提高老年急性心肌梗死患者肺部感染的防治能力。方法回顾性分析2009年11月-2012年11月在医院治疗的168例老年急性心肌梗死患者临床资料,总结其发生肺部感染的独立危险因素,提出针对性的护理措施。结果 168例老年急性心肌梗死患者发生肺部感染40例,感染率23.8%;老年急性心肌梗死患者发生肺部感染与其高龄、合并泵功能不全性心律失常、不稳定性心律失常、急性房室传导阻滞、住院时间长有关;40例肺部感染患者死亡12例,病死率为30.0%,128例非肺部感染患者死亡4例,病死率为3.13%,差异有统计学意义(P<0.05)。结论老年急性心肌梗死患者发生肺部感染病死率高,针对该类患者发生肺部感染的高危因素,采取针对性的护理措施,尽可能降低患者发生肺部感染的发生率,以提高患者的预后质量。

OBJECTIVE To analyze the clinical features of pulmonary infection in patients with acute myocardial infarction ,summarize risk factors for pulmonary infection in patients with acute myocardial infarction ,discuss clinical nursing measures to improve prevention and treatment of pulmonary infection in elderly patients with acute myocardial infarction .METHODS A retrospective analysis was conducted on the clinical data of 168 patients with acute myocardial infarction treated in our hospital in Nov .2009-Nov .2012 .The independent risk factors for pul‐monary infection were summarized ,and the specific nursing measures were put forward .RESULTS Totally 40 out of 168 elderly patients with acute myocardial infarction had pulmonary infection with the infection rate of 23 .8% . The incidence of pulmonary infection in patients with elderly acute myocardial infarction was associated with advanced age ,combination with arrhythmias due to pump dysfunction ,unstable arrhythmia ,acute atrioventricular block ,and prolonged hospitalization .Totally 12 out of the 40 patients with pulmonary infection died with the mor‐tality of 30 .0% ,and 4 out of 128 patients with non‐pulmonary infections died with the mortality of 3 .13% ;there was significant difference in the mortality rate （P〈0 .05） .CONCLUSION Pulmonary infection in patients with a‐cute myocardial infarction has high mortality .Clinicians should take targeted nursing measures according to the high risk factors of pulmonary infection in this type of patients to minimize the incidence of pulmonary infection rate in order to improve the quality of the patient＇s prognosis .