摘要
目的 探究急性心肌梗死合并恶性心律失常患者治疗后延长重症监护室停留时间的因素。方法 回顾性收集2021年5月~2023年4月在新疆医科大学第一附属医院进行治疗的急性心肌梗死合并恶性心律失常患者112例。按照是否发生重症监护室留置延长分为2组,分别是延长组(27例)和无延长组(85例)。收集比较患者的一般资料情况,如年龄、是否血脂异常、急性心肌梗死的类型等。对患者是否出现重症监护室留置时间延长进行影响因素分析。结果 112例急性心肌梗死合并恶性心率失常患者中治疗发生重症监护室时间延长的患者有27例,未发生重症监护室时间延长的患者85例。两组患者在性别、吸烟、饮酒、冠心病、心脏起搏器、入重症监护室原因以及左室射血分数的比较中差异无统计学意义(P> 0.05);而年龄、血脂异常以及糖尿病比较,差异有统计学意义(P<0.05)。对符合P<0.05的单因素(年龄、血脂异常有=1,无=0、糖尿病有=1,无=0)进行多因素logistic分析,共线性诊断VIF> 10的因子予以删减,结果显示,血脂异常、年龄、糖尿病是重症监护室留置时间延长的影响因子(P<0.05),Y=3.647×年龄+2.439×血脂异常+1.404×糖尿病-0.206。构建的模型Hosmer-Lemeshow检验显示模型拟合度良好,P=0.883,决定系数R^(2 )=0.499,进一步使用ROC对所获得预测模型进行预测效能的评价,曲线下面积0.849,P=0.000,95%CI=0.774~0.924。结论 血脂异常、年龄以及糖尿病是重症监护室留置时间延长的独立影响因子,在重症监护室治疗期间,医生需要对患者的病情进行密切观察和评估,及时调整治疗方案,以降低并发症的风险、改善患者预后和生活质量。
Objective To explore the factors that prolong the stay time in the intensive care unit(ICU)of patients with acute myocardial infarction complicated with malignant arrhythmia after treatment.Methods Patients with acute myocardial infarction complicated with malignant arrhythmia treated in our hospital from May 2021 to April 2023 were retrospectively collected,and 112 patients were selected as the research object.According to whether the ICU stay was prolonged or not,they were divided into two groups,namely the extended group(27 cases)and the non-extended group(85 cases).Collect the general information of patients,such as age,dyslipidemia,type of acute myocardial infarction,etc.,and further test and compare.The influencing factors were analyzed whether the patients had prolonged detention time in the ICU.Results Among 112 patients with acute myocardial infarction complicated with malignant arrhythmia,27 patients were treated with prolonged ICU time,and 85 patients were not treated with prolonged ICU time.There were no significant differences between the two groups in sex,smoking,drinking,coronary heart disease,pacemaker,reasons for entering the ICU and left ventricular ejection fraction(P>0.05),but there were significant differences in age,dyslipidemia and diabetes(P<0.05).According to the results of general data analysis,exclude the factor of P>0.05,and assign values to the single factors(age,dyslipidemia=1,none=0,diabetes=1,none=0)that meet P<0.05,and carry out multivariate Logistic analysis,and delete the factors with collinear diagnosis VIF greater than 10.The results show that dyslipidemia,age and diabetes are.Hosmer-Lemeshow test shows that the model has a good fitting degree,P=0.883,and the determining coefficient R2 is 0.499.Furthermore,ROC is used to evaluate the prediction efficiency of the obtained prediction model,and the area under the curve is 0.849,P=0.000,and the 95%CI is 0.774~0.924.Conclusion Dyslipidemia,age and diabetes are independent influencing factors of prolonged stay in ICU.During the trea
作者
张晓静
王宝珠
陈志苑
董霞
魏琴情
Zhang Xiaojing;Wang Baozhu;Chen Zhiyuan(Cardiovascular Disease Center Intensive Care Unitthe,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830001,China)
出处
《中华保健医学杂志》
2024年第4期403-406,共4页
Chinese Journal of Health Care and Medicine
基金
新疆维吾尔自治区重点研发计划项目(2022B03022-5)。
关键词
急性心肌梗死
恶性
心律失常
重症监护室
Acute myocardial infarction
Malignant
Arrhythmia
Intensive care unit
