老年肺血栓栓塞症患者血流动力学的变化及影响因素

发布时间：2018-07-23 11:03

【摘要】：目的探讨老年肺血栓栓塞症患者血流动力学的变化及影响因素。方法选择70岁以上老年肺血栓栓塞症患者100例作为肺血栓栓塞症组,70岁以上老年健康体检者100例作为对照组。肺血栓栓塞症组患者根据是否合并肺动脉高压分为肺动脉高压组(59例)和非肺动脉高压组(41例)。收集患者的临床资料及平均动脉压(MAP)、心脏指数(CI)、每搏输出量(CO)、每搏指数、心率、胸腔静脉血压、体血管阻力、肺血管阻力等血流动力学指标。结果肺血栓栓塞症组MAP、CI、CO、每搏指数明显均明显低于对照组(P0.05),肺血栓栓塞症组心率、胸腔静脉血压、体血管阻力、肺血管阻力均明显高于对照组(P0.05)。肺动脉高压组年龄明显高于非肺动脉高压组,血小板计数低于非肺动脉高压组,女性、晕厥、V1~3 T波倒置比例明显高于非肺动脉高压组;肺动脉高压组吸烟、高血压、脑卒中、癌症、外伤或手术、呼吸困难、胸膜炎性胸痛、咯血、胸闷、心悸、咳嗽、D-二聚体、右束支传导阻滞、深静脉血栓形成的比例与非肺动脉高压组比较均无统计学差异(P0.05)。Logistic多因素回归分析结果显示:性别和年龄是肺血栓栓塞症合并肺动脉高压的独立危险因素(P0.05)。结论老年肺血栓栓塞症患者存在血流动力学改变,性别和年龄是老年肺血栓栓塞症合并肺动脉高压的独立危险因素。
[Abstract]:Objective to investigate the changes of hemodynamics in elderly patients with pulmonary thromboembolism and its influencing factors. Methods 100 patients over 70 years old with pulmonary thromboembolism were selected as control group. Pulmonary thromboembolism group was divided into pulmonary hypertension group (59 cases) and non pulmonary hypertension group (41 cases). The clinical data, mean arterial pressure (map), cardiac index (CI), stroke output (CO), heart rate, thoracic vein blood pressure, body vascular resistance and pulmonary vascular resistance were collected. Results in the pulmonary thromboembolism group, the stroke index per stroke was significantly lower than that in the control group (P0.05). The heart rate, thoracic vein blood pressure, body vascular resistance and pulmonary vascular resistance in the pulmonary thromboembolism group were significantly higher than those in the control group (P0.05). The age of pulmonary hypertension group was significantly higher than that of non-pulmonary hypertension group, the platelet count was lower than that of non-pulmonary hypertension group, and the ratio of V1-T wave inversion of syncope in female was significantly higher than that in non-pulmonary hypertension group, and the ratio of smoking, hypertension and stroke in pulmonary hypertension group was significantly higher than that in non-pulmonary hypertension group. Cancer, trauma or surgery, dyspnea, pleural pain, hemoptysis, chest tightness, palpitations, cough with D-dimer, right bundle branch block, The proportion of deep venous thrombosis was not significantly different from that of non-pulmonary hypertension group (P0.05). Logistic regression analysis showed that sex and age were independent risk factors for pulmonary thromboembolism complicated with pulmonary hypertension (P0.05). Conclusion there are hemodynamic changes in elderly patients with pulmonary thromboembolism. Sex and age are independent risk factors of pulmonary hypertension in elderly patients with pulmonary thromboembolism.
【作者单位】：台州市中心医院台州学院附属医院重症监护室;
【分类号】：R563.5

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