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老年2型糖尿病合并急性心肌梗死患者的临床特点及护理对策OA

Clinical characteristics and nursing strategies of elderly patients with type 2 diabetes mellitus complicated with acute myocardial infarction

中文摘要英文摘要

目的 分析老年 2 型糖尿病合并急性心肌梗死(acute myocardial infarction,AMI)患者的临床特点及护理对策.方法 选取 2019 年 1 月至 2021 年 12 月江苏省人民医院收治的 138 例老年 2 型糖尿病合并AMI患者纳入观察组,无糖尿病的AMI患者 346 例纳入对照组.收集两组患者的临床资料、并发症、冠状动脉造影结果、预后情况并比较.结果 观察组患者的吸烟率、高血压比例、典型胸痛比例均显著低于对照组,高脂血症比例、Killip 分级≥Ⅲ级比例均显著高于对照组(P<0.05);观察组患者的三支病变或左主干病变比例显著高于对照组(P<0.05);观察组患者的心律失常、急性心力衰竭、肺部感染发生率均显著高于对照组(P<0.05),两组患者的心源性休克、住院期间心源性死亡发生率比较差异均无统计学意义(P>0.05).结论 老年 2 型糖尿病合并AMI患者的临床症状不典型,合并症较多,医护人员早期识别并积极控制心血管危险因素,可降低患者死亡率,改善其远期预后.

Objective To analyze the clinical characteristics and nursing strategies of elderly patients with type 2 diabetes mellitus complicated with acute myocardial infarction(AMI).Methods A total of 138 elderly patients with type 2 diabetes mellitus combined with AMI admitted to Jiangsu Province Hospital from January 2019 to December 2021 were included in observation group,and 346 patients with AMI without diabetes mellitus were enrolled in control group.The clinical data,complications,coronary angiography results and prognosis of two groups were collected and analyzed.Results The proportion of smoking,hypertension and typical chest pain in observation group were significantly lower than those in control group,while the proportion of hyperlipidemia and Killip grade≥Ⅲ were significantly higher than those in control group(P<0.05).The proportion of patients with three branch lesions or left main trunk lesions in observation group were significantly higher than those in control group(P<0.05).The incidences of arrhythmia,acute heart failure and pulmonary infection in observation group were significantly higher than those in control group(P<0.05).There was no significant difference in the incidence of cardiogenic shock and cardiac death during hospitalization between two groups(P>0.05).Conclusion Elderly patients with type 2 diabetes mellitus complicated with AMI have atypical clinical symptoms and more complications.Early identification and active control of cardiovascular risk factors by medical staff can reduce the mortality of patients and improve the long-term prognosis.

许艳玲;史冬梅;蒋宏粉;陈韦

南京医科大学第一附属医院(江苏省人民医院)心血管科,江苏南京 210029

临床医学

老年;2型糖尿病;急性心肌梗死;临床特点

Elderly;Type 2 diabetes mellitus;Acute myocardial infarction;Clinical characteristics

《中国现代医生》 2024 (001)

85-87,91 / 4

10.3969/j.issn.1673-9701.2024.01.021

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