急性心肌梗死患者主动脉内球囊反搏术后下呼吸道感染的风险与预后研究  

Risk of lower respiratory tract infections in patients with acute myocardial infarction undergoing intra-aortic balloon counterpulsation

作　　者：楼洋[1] 陈献国[1] 许博[1] 周志有[1] 饶效 

机构地区：[1]金华市中心医院心胸外科,浙江金华321000

出　　处：《中华医院感染学杂志》2016年第3期575-577,共3页Chinese Journal of Nosocomiology

基　　金：浙江省科技厅研究基金资助项目(ZJ211474-03);浙江省金华市社会发展类重点基金项目(2013-3-013)

摘　　要：目的探讨急性心肌梗死患者行主动脉内球囊反搏术(IABP)后发生下呼吸道感染风险及临床特点,为临床治疗提供参考。方法随机选取2012年1月-2015年1月急性心肌梗死行主动脉内球囊反搏术(IABP)后发生下呼吸道感染的58例患者为观察组,另选择同期未发生下呼吸道感染的58例患者为对照组,比较两组患者的临床特征分布特点,并分析患者术后发生下呼吸道感染的危险因素,统计患者治疗前后并发症发生率。结果对照组患者在性别、左心室射血分数、合并呼吸道疾病以及合并肾功能不全等方面与对照组比较差异无统计学意义,而在年龄、术前白细胞水平、抗菌药物使用种类及使用时间、深静脉置管、有创通气以及是否合并糖尿病等与对照组比较差异有统计学意义(P<0.05)。结论内球囊反搏术后发生下呼吸道感染的主要相关因素多,应采取干预措施,以降低患者术后下呼吸道感染的风险。OBJECTIVE To explore the risk of lower respiratory tract infections in the acute myocardial infarction patients undergoing intra-aortic balloon counterpulsation（IABP）and analyze the clinical characteristics so as to provide guidance for clinical treatment.METHODS A total of 58 acute myocardial infarction patients who underwent the IABP from Jan 2012 to Jan 2015 and were complicated with postoperative lower respiratory tract infections were randomly selected as the observation group,meanwhile,58 patients without lower respiratory tract infections were chosen as the control group.The clinical characteristics were compared between the two groups of patients,the risk factors for the postoperative lower respiratory tract infections were analyzed,and the incidence of complications was statistically analyzed before and after the treatment.RESULTS There was no significant difference in the genders,left ventricular ejection fraction,complication of respiratory tract disease,or complication of renal dysfunction between the control group and the control group;however,there was significant difference in the age,preoperative level of white blood cells,types of antibiotic,time of use of antibiotic,deep venous catheter indwelling,invasive ventilation,or complication of diabetic mellitus between the observation group and the control group（P〈0.05）.CONCLUSIONThere are a variety of related factors for the postoperative lower respiratory tract infections in the patients undergoing IABP.It is necessary to take intervention measures so as to reduce the risk of the postoperative respiratory tract infections.

关 键 词：急性心肌梗死 主动脉内球囊反搏术 下呼吸道感染 

分 类 号：R563.1[医药卫生—呼吸系统]