危重症患者心力衰竭的危险因素分析

目的:探讨危重症患者心力衰竭的发病情况、临床特征及相关影响因素.方法:选择危重症患者477例,对其中出现心力衰竭患者采用多普勒超声心动图进行评估,对心力衰竭患者(A组)与非心力衰竭患者(B组)的年龄、性别、基础疾病及症状等进行比较和分析.结果:477例危重症患者中161例(33.8%)出现心力衰竭(A组),且A组中53.4%的患者左心室射血分数≥50%.A组患者年龄显著高于B组(P<0.01),2组患者性别差异无统计学意义(P>0.05).对心力衰竭危险因素的logistic回归分析显示,患者伴发瓣膜性心脏病、冠心病、糖尿病、肾功能不全及呼吸衰竭均可提高患者心力衰竭风险(P<0.05).结论:在对重症患者基础疾病积极治疗的过程中,应针对心力衰竭危险因素加强相关监测,采取有效的干预措施,降低心力衰竭发生率,提高危重症患者的救治成功率.

Analysis of the risk factor of heart failure in critically ill patients

Objective:To explore the incidence,clinical characteristics and related factors of heart failure in critically ill patients. Methods:The heart failure in 477 critically ill patients were evaluated by Doppler echocardiography. The patients with and without heart failure were divided into the heart failure group( group A) and non-heart failure group( group B) ,respectively. The mean age,sex,basic disease and symptom between two groups were compared and analyzed. Results:Among the critically ill patients,161 cases(33. 8%) with heart failure were identified,and the left ventricular ejection fraction in 53. 4% patients of group A were more than or equal to 50%. The age in group A was more than that in group B(P<0. 01),and the difference of sex between two groups was not statistically significant(P>0. 05). Logistic regression analysis of the risk factors showed that the valvular heart disease,coronary heart disease, diabetes mellitus,renal insufficiency and respiratory failure could increase the occurrence of heart failure(P<0. 05). Conclusions:During the process of active treating the basic disease,strengthening the monitoring of the relevant risk factors of heart failure,taking the effective intervention measures and reducing the incidence of heart failure can improve the success rate of emergency treatment of critically ill patients.