急性心肌梗死患者合并感染的危险因素分析及护理对策

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

目的 探讨急性心肌梗死 (acutemyocardialinfarction ,AMI)患者合并感染的危险因素及护理对策。方法 对 5 4例AMI患者进行回顾性分析 ,2 8例AMI患者进行前瞻性调查。结果 82例AMI患者中发生急性感染病例 2 2例 ,感染发生比例为 2 6.83 %。通过单因素分析发现 :年龄、心脏左室射血分数 (LVEF)、卧床天数、合并高血压病史等因素与AMI患者发生感染有显著的关系 (P<0 0 1)。感染部位以肺部感染最为常见 ,占总感染数的 81.82 % ,其次为泌尿系感染 ( 2 7.2 7% )。感染致病菌类型 (以细菌培养结果为准 ) :以革兰阳性球菌多见 ,其中草绿色链球菌最常见 ,其次为白色念珠菌 ;泌尿系感染尿培养为大肠埃希菌。结论 年龄大、心脏射血分数低、卧床天数长、合并高血压病史是AMI患者容易合并感染的主要危险因素。

Objective To analyze the risk factors of infection in acute myocardial infarction (AMI) patients and nursing management to prevent the infection.Methods Retrospective analysis of 54 cases of in hospitalized AMI patients in Cardiology Department,General Hospital of PLA from January 2002 to September 2002 and prospective analysis of 28cases of AMI enrolled from January 2003 to March 2003 were conducted.Results There were 22(26.83%) cases of acute infection in 82 AMI patients. Single factor analysis indicated that age, ejection fraction of left ventricle (LVEF),days restricted to bed and history of hypertension were related to infection in AMI patients (P<0.01).Lung was the most frequently affected organ; there were 18(81.82%) cases of lung infection, followed by 6(27.22%) cases of urinary tract infection.Gram-positive cocci especially streptococci were the main pathogen detected by culture. The second mostly encountered bacteria were Candida albicans.Escherichia coli were found in urinary tract infection patients.Conclusion old age, low EF, long duration of bed restriction and history of hypertension were the risk factors of infection in AMI patients.