心血管内科患者院内猝死高风险因素调查分析  

Investigation of high risk factors of sudden death in cardiovascular department

作　　者：刘海燕[1] 鲁琰[1] 于艳艳[1] 张丽敏[1] 潘红霞[1] 刘亚平[1] 

机构地区：[1]泰达国际心血管病医院,天津300457

出　　处：《天津护理》2015年第3期194-196,共3页Tianjin Journal of Nursing

基　　金：天津市卫生局科技基金项目(2012KZ011)

摘　　要：目的:探讨急性冠脉综合征住院患者发生猝死的高危因素,指导临床护理对策制定。方法:收集心内科住院的912例急性冠脉综合征患者,将生存与猝死患者数据进行单因素和多因素Logistic回归分析。结果:单因素分析结果显示高龄、女性、不饮酒、心衰、肌钙蛋白(TNI)升高、室壁瘤、未再灌注治疗、室性心律失常、高度房室传导阻滞、肾功能不全与生存组比较有统计学意义(P<0.05)。经多因素Logistic回归分析高龄、高度房室传导阻滞、室颤、未再灌注治疗与猝死的发生有统计学意义。猝死病例中心脏破裂、心源性休克为主要猝死病因占67.5%。结论:高龄、高度房室传导阻滞、室颤、未再灌注治疗是心内科急性冠脉综合征住院患者发生猝死最显著的独立相关危险因素,心脏破裂、心源性休克为主要猝死病因。因此护理人员有针对性的加强以上危险因素的控制及管理对预防猝死的发生有重要的临床意义。Objective： To investigate the cases of sudden death in patients with acute coronary syndrome in order to find out the high risk factors and guide the development of clinical nursing countermeasures. Methods： 912 survival and sudden death patients with acute coronary syndrome were analyzed by single factor analysis and multivariate logistic regression analysis. Results： The single factor analysis showed that the statistical significance factors were senility, women, no drink, heart failure, cardiac troponin I （TN1） increased, left ventricular aneurysm, no reperfusion therapy, ventricular arrhythmia, high degree of atrioventricular block and renal dysfunction （P〈0.05）. Multivariate Logistic regression analysis indicated that the risk factors of sudden death were senility, high-grade atrioventricular block, ventficular fibrillation, without reperfusion therapy. Cardiac rupture and cardiogenic shock turned out to be the main factors which account for 67.5% sudden death. Conclusion： Sudden death of patients with acute coronary syndrome is a combined result of many factors. Advanced age, high-grade atrioventricular block, ventricular fibrillation, without reperfusion therapy are the most significant independent risk factors of sudden death in patients with acute coronary syndrome hospitalized in department of cardiology, but other risk factors can not be ignored. Therefore nursing staff should strengthen management for the above risk factors, which will have important clinical value for the prevention of sudden death.

关 键 词：心血管内科 急性冠脉综合征 院内猝死 高风险因素 

分 类 号：R186[医药卫生—流行病学]