摘要
目的探讨冠心病患者医院获得性肺炎的临床特点及防治措施。方法对2005年3月-2009年3月1287例住院冠心病患者,进行回顾性调查分析研究。结果医院获得性肺炎24例(1.86%),其病原菌以革兰阴性杆菌为主;冠心病患者发生医院获得性肺炎与高龄、冠脉C型病变、合并糖尿病、合并慢性支气管炎、介入术后卧床制动因素相关;冠心病患者介入术后合并医院获得性肺炎组,住院期间临床不良事件包括经皮冠状动脉介入治疗(PCI)术后心绞痛再发、急性心力衰竭、室性心律失常(≥Lown3级)的发生率分别为23.5%、17.6%、29.4%,与无医院获得性肺炎组比较差异有统计学意义(P<0.05)。结论医院获得性肺炎对冠心病介入术后患者住院期间临床事件的发生有着不良影响,高龄、高危冠脉病变、合并糖尿病、慢性支气管炎是冠心病患者发生肺部医院感染的相关危险因素,对冠心病患者的医院获得性肺炎应以预防为主,采取综合治疗措施予以控制。
OBJECTIVE To investigate the clinical characteristics of the hospital-acquired pneumonia （HAP） in the patients with coronary heart diseases. METHODS A retrospective study was carried out to investigate the clinical data of 1287 patients with coronary heart diseases during from Mar 2005 to Mar 2009. RESULTS From them 24 cases （1.86%） were with HAP in the study. The pathogens were mainly Gram-negative bacilli. The HAP was related positively to elderly, type C coronary lesions, diabetes mellitus, chronic bronchitis, and keeping the bed and limb immobilizing. During the hospitalized period, the incidences of clinical adverse events included recurrence of angina pectoris after Percutaneous Coronary intervention（PCI）, acute heart failure, and ventricular arrhythmia （Lown ≥3 grade） being 23.5 %, 17.6% and 29.4%, There was significant difference in clinical adverse events between the patients undergoing PCI with HAP group and non-HAP group （P〈 0. 05）. CONCLUSIONS The HAP has adverse influence on clinical events of patients with coronary heart diseases undergoing PCI during the hospitalized period. The elderly, high risk coronary lesions, diabetes mellitus, chronic bronchitis, keeping the bed and limb immobilizing are the risk factors of HAP in patients with coronary heart diseases. More attention should be focused on prevention in patients with coronary heart diseases, and should take active measures to the related risk factors for controlling the occurrence of the HAP.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2010年第11期1550-1552,共3页
Chinese Journal of Nosocomiology
关键词
冠心病
医院获得性肺炎
Coronary heart diseases
Hospital-acquired pneumonia
