摘要
目的 探究高龄呼吸机相关肺炎(VAP)患者诱发心血管事件的相关影响因素,并分析预防措施。方法 收集2018年9月-2021年3月接受治疗的高龄VAP患者112例,作为观察对象。调查患者并发CVE的情况(发生率、病种分布),同时收集患者临床资料,分析高龄VAP患者诱发CVE的单因素与多因素。结果 112例高龄VAP患者并发CVE 39例(34.82%),且多见于新发心力衰竭、新发心力衰竭+房性心动过速、心力衰竭恶化;慢性心血管疾病、APACHE-Ⅱ评分>15分、血糖、血Scr、PCT是高龄VAP患者并发CVE的独立危险性因素(P<0.05);VAP发生后立即拔管、据药敏试验使用抗生素、半卧位体位、动脉血pH值<7.35是高龄VAP患者并发CVE的独立保护性因素(P<0.05)。结论 慢性心血管疾病、APACHE-Ⅱ评分>15分、血糖、血Scr、PCT均会增加高龄VAP患者并发CVE的危险性,而平衡动脉血酸碱值、保护肾功能、控制血糖、合理使用抗生素能辅助降低高龄VAP患者并发CVE的概率。
Objective To explore related factors of cardiovascular events for elderly patients with ventilator-associated pneumonia (VAP) and analyze preventive measures.Methods The paper chose 112 cases elderly VAP patients from September 2018 to March 2021 as observation objects,and investigated situation of patients complicated with CVE (incidence and disease distribution),collected their clinical data,and analyzed single factor and multi factors of CVE induced by elderly VAP patients.Results There were 39 cases (34.82%) among 112 elderly VAP patients complicated with CVE,mostly found in new heart failure,new heart failure+atrial tachycardia and deterioration of heart failure.Chronic cardiovascular disease,Apache-Ⅱ scores>15,blood glucose,blood SCR and PCT were independent risk factors of CVE for elderly VAP patients (P<0.05).Extubation immediately after VAP,antibiotic use according to drug sensitivity test,semi recumbent position and arterial blood pH value<7.35 were independent protective factors of CVE for elderly patients with VAP (P<0.05).Conclusion Chronic cardiovascular disease,Apache-Ⅱ scores>15,blood glucose,blood SCR and PCT can increase risks of CVE for elderly VAP patients.Balancing arterial blood pH,protecting renal function,controlling blood glucose and rational use of antibiotics can reduce risks of CVE for elderly VAP patients.
作者
陈赞嫦
李小敏
罗桥丽
陈燕
张绮文
CHEN Zanchang;LI Xiaomin;LUO Qiaoli;CHEN Yan;ZHANG Qiwen(Guangdong Medical University Third Affiliated Hospital(Longjiang Hospital),Foshan,Guangdong,528318;Guangzhou Medical University Traditional Chinese Medicine Affiliated Hospital,Guangzhou,Guangdong,510000)
出处
《智慧健康》
2022年第15期65-68,共4页
Smart Healthcare
关键词
高龄患者
VAP
心血管事件
相关影响因素
预防措施
Elderly patients
VAP
Cardiovascular events
Relevant influencing factors
Preventive measures
