论著
目的 探讨全身麻醉(全麻)髋关节置换术后苏醒期患者家属迁移应激水平及其相关影响因素。方法 选取2021年4月—2022年10月在南昌市洪都中医院行全麻髋关节置换术苏醒期的108例患者,使用ICU转出患者家属应激压力评估量表评价患者家属迁移应激水平,调查患者及家属相关资料,分析全麻髋关节置换术后苏醒期患者家属迁移应激水平的相关影响因素。结果 108例全麻髋关节置换术后苏醒期患者家属迁移应激得分为(56.35±5.86)分,家属迁移应激水平中等;经多元线性回归分析显示,患者麻醉重症监护室(AICU)住院时间≥24 h、女性、文化水平初中及以下、消极应对是全麻髋关节置换术后苏醒期患者家属迁移应激水平升高的危险因素(P<0.05)。结论 全麻髋关节置换术后苏醒期患者家属迁移应激水平中等,受患者AICU住院时间、家属性别、文化水平、应对方式因素影响。
Objective To analyze the levels of relocation anxiety and its related influencing factors in the family members of patients during the recovery period after hip arthroplasty under general anesthesia.Methods From April 2021 to October 2022,108 patients in Nanchang Hongdu Traditional Chinese Medicine Hospital undergoing total hip arthroplasty under general anesthesia were selected.The levels of relocation anxiety in their families were evaluated using the ICU transferred out patient family stress assessment scale,and the relevant data of the patients and their families were investigated.The relevant factors affecting the levels of relocation anxiety in their families during the recovery period after total hip arthroplasty under general anesthesia were analyzed.Results The relocation anxiety score of 108 patients’ family members during the recovery period after hip arthroplasty under general anesthesia was(56.35±5.86),with a moderate level.Multiple linear regression analysis showed that patients’ AICU hospitalization time≥24 hours,women,education level of junior high school or below and negative coping were the influencing factors for the level of relocation anxiety of family members of patients during the recovery period after hip replacement under general anesthesia(P<0.05).Conclusions The level of relocation anxiety in family members of patients undergoing general anesthesia and hip arthroplasty during the recovery period is moderate,which is influenced by factors such as length of patients’ stay in AICU,family members’ gender,educational level and coping styles.
中西医结合/中医研究
老年人工股骨头置换术后隐性失血是影响手术的重要因素之一,手术后机体生理、病理的变化是一个较为复杂的过程。目前中医对其病因病机尚无系统研究。临床中常存在辨证思维局限,难以客观、全面揭示该病病因病机的特点,进而导致遣方用药难以把握。该文旨在对老年人工股骨头置换术后隐性失血的病因病机进行探讨,认为该病的证候特点为气血亏虚兼瘀,病性为本虚标实,病位肝脾肾,其中气血亏虚贯穿疾病始终,而气为关键。
Hidden blood loss after artificial femoral head replacement in the elderly is one of the important factors affecting the operation,and the change of physiology and pathology after operation is a complicated process.At present,there is no systematic study on its etiology and pathogenesis in traditional Chinese medicine.In clinical practice,there are limitations of dialectical thinking,which make it difficult to Objective ly and comprehensively reveal the characteristics of the etiology and pathogenesis of the disease,and difficult to prescribe.The purpose of this paper is to explore the etiology and pathogenesis of hidden blood loss after artificial femoral head replacement in the elderly.It is considered that the syndrome of the disease is characterized by deficiency of qi and blood and blood stasis,and the disease is based on deficiency of liver,spleen and kidney,in which deficiency of qi and blood runs through the disease all the time,and qi is the key.
论著
目的 分析烟雾病患者在血管重建术并发脑高灌注综合征的危险因素,为指导预防血管重建术后并发症提供参考依据。方法 选择2022年9月—2023年9月期间医院接收的148例烟雾病患者为研究对象,采用血管重建术治疗,统计术后高灌注综合征发生率,单因素分析术后并发高灌注综合征与性别、年龄、既往史、类型、铃木分期、灌注分期、手术侧别、入院改良Rankin 量表(mRS)评分、术后脑血流量(CBF)等因素的关系,并采取非条件Logistic多因素回归分析烟雾病患者血管重建术后并发高灌注综合征的危险因素。结果 148例患者血管重建术后,共42例并发脑高灌注综合征,发生率为28.38%。其中术后并发脑高灌注综合征与无并发脑高灌注综合征患者的性别、总胆固醇、甘油三酯、空腹血糖、入院mRS评分及基础疾病类型、手术侧别和手术时间比较差异无统计学意义(P>0.05)。烟雾病血管重建术后并发脑高灌注综合征患者年龄、是否合并高血压、铃木分期、灌注分期、收缩压、舒张压、术后CBF与无脑高灌注综合征患者比较差异有统计学意义(P<0.05)。年龄、收缩压、舒张压、铃木分期、灌注分期、CBF为烟雾病血管重建术后并发脑高灌注综合征的影响因素(P<0.05)。结论 烟雾病患者血管重建术后并发高灌注综合征的危险因素主要为高龄、收缩压升高、舒张压升高、铃木分期中晚期、灌注分期高、CBF降低,对此类患者需引起重视,做好针对性干预。
论著
目的 调查与探讨高龄髋部骨折患者术后谵妄(POD)的发生因素,并提出相关处理对策。方法 选取2019年8月—2022年12月择在南阳市中医院独山院区进行手术治疗的高龄髋部骨折患者82例为研究对象,所有患者在术前1 d进行机械痛阈评定,在术后7 d判定患者的POD发生情况,进行POD与术前痛阈水平的相关性分析,并提出相关的处理对策。结果 术后7 d,82例患者中发生POD 12例(谵妄组),占比14.6%,未发生POD 70例(非谵妄组),占比85.37%。谵妄组的性别、体质指数、骨折类型、骨折至手术时间与非谵妄组对比差异无统计学意义(P>0.05),谵妄组的年龄、术前血红蛋白水平、术前白蛋白水平与非谵妄组对比差异有统计学意义(P<0.05)。谵妄组的术前1 d的痛阈水平低于非谵妄组(P<0.05)。Spearman分析显示,POD与术前痛阈、年龄、术前血红蛋白、术前白蛋白均存在相关性(P<0.05)。Logistic回归分析显示,术前痛阈、年龄、术前血红蛋白、术前白蛋白等都为导致POD发生的影响因素(P<0.05),要积极加强预防性护理干预。结论 高龄髋部骨折患者POD的发生率较高,患者的术前痛阈、年龄、术前血红蛋白、术前白蛋白等均为导致POD发生的影响因素,要积极加强预防性护理干预。
Objective To investigate and explore the factors leading to postoperative delirium(POD)in elderly patients with hip fractures,and to propose relevant handling measures.Methods From August 2019 to December 2022,82 cases of elderly patients with hip fractures who underwent surgical treatment in Nanyang Hospital of Traditional Chinese Medicine Dushan District were selected as the research subjects.All patients underwent mechanical pain threshold assessment 1 day before surgery,and their postoperative delirium were determined 7 days after surgery,followed by correlation analysis,and relevant handling measures were proposed.Results Seven days after surgery,there were 12 patients(delirium group)of POD,accounted for 14.6%,and 70 patients(non delirium group)without POD,accounted or 85.37%.There was no significant difference in genders,body mass index,fracture types and fracture to surgery time compared between the delirium group and the non delirium group(P>0.05). However,there were significant differences in ages,preoperative hemoglobin levels and preoperative albumin levels compared between the delirium group and the non delirium group(P<0.05).The pain threshold level of the delirium group on the first day before surgery was significantly lower than that of the non delirium group(P<0.05).Spearman analysis showed that POD was associated with preoperative pain threshold,ages,preoperative hemoglobin and preoperative albumin levels(P<0.05).Logistic regression analysis showed that the preoperative pain threshold level,ages,preoperative hemoglobin and preoperative albumin levels were all independent risk factors for the development of POD(P<0.05),preventive nursing intervention should be actively strengthened.Conclusions The incidence of POD is high in elderly patients with hip fractures.Preoperative pain threshold level,age,preoperative hemoglobin and preoperative albumin levels are all factors that contribute to the occurrence of POD.It is necessary to actively strengthen preventive nursing interventions.
论著
目的 探讨个体化肠内营养支持在胃肠术后早期应用的可行性及安全性。方法 选取2022年1月—12月安徽省亳州市中医院普通外科收治的胃肠手术患者100例。使用随机数字表法将患者随机为观察组和对照组,每组各50例。观察组在常规治疗基础上实施个体化肠内营养,持续7 d。对照组则接受术后常规处理。术后第7天测定实验室指标,并比较两组胃肠功能的恢复情况。结果 观察组术后肛门首次排气时间短于对照组[(55.41±19.63)h vs (81.46±19.39) h],前白蛋白水平高于对照组[(241.14±65.73)g/L vs(217.35±51.63)g/L],组间比较差异有统计学意义(P<0.05)。血清总蛋白水平[(70.55±18.89)g/L vs (68.16±20.05)g/L]、血清白蛋白水平[(53.22±17.76)g/L vs(50.76±18.54)g/L]、淋巴细胞计数[(1.60±0.54)×109/L vs (1.56±0.55)×109/L]以及肛门排便时间[(89.67±22.31)h vs (97.77±21.27)h ]在组间比较差异无统计学意义(P>0.05)。结论 根据个体情况在胃肠术后早期实施个体化的肠内营养支持是安全可行的,能够促进胃肠功能的快速恢复,从而改善患者的营养状况。
Objective To investigate the feasibility and safety of personalized enteral nutrition support during the early postoperative period of gastrointestinal surgery.Methods A total of 100 patients who underwent gastrointestinal surgery at the Department of General Surgery,Bozhou Hospital of Traditional Chinese Medicine,who were enrolled in this study during January 2022 to December 2022.Patients were randomly allocated into either the observational or control group,with 50 patients in each group.The randomization was performed using a random number table.The observational group received personalized enteral nutrition support in addition to routine treatment for 7 days.The control group received standard postoperative care.Laboratory indicators were measured on the 7th postoperative day to compare recovery of gastrointestinal function between the two groups.Results The observational group exhibited a significantly shorter time to the first passage of flatus from the anus compared to the control group(55.41±19.63 h vs 81.46±19.39 h,P<0.05),as well as higher prealbumin levels(241.14±65.73 g/L vs 217.35±51.63 g/L,P<0.05).However,there were no significant differences between the two groups in terms of serum total protein levels(70.55±18.89 g/L vs 68.16±20.05 g/L),serum albumin levels(53.22±17.76 g/L vs 50.76±18.54 g/L),lymphocyte counts[(1.60±0.54)×109/L vs (1.56±0.55)×109/L],and time to the first defecation from the anus(89.67±22.31 h vs 97.77±21.27 h)(all P>0.05).Conclusions Personalized enteral nutrition support based on individual conditions is safe and feasible in the early postoperative period of gastrointestinal surgery.It can promote the rapid recovery of gastrointestinal function and improve patients' nutritional status.
论著
目的 分析恶性梗阻性黄疸患者实施经皮肝穿刺胆道引流术后出院准备度情况,探究此类患者出院准备度的影响因素。方法 选择2020年9月—2023年4月于天津市人民医院消化内科接受经皮肝穿刺胆道引流术的80例恶性梗阻性黄疸患者,选择院内系统对入组患者的性别、年龄等资料进行统计,并使用出院准备度量表评估患者出院准备度,应用出院指导质量量表评估患者出院指导质量,选择Pearson相关性分析的措施对影响患者出院准备度和出院指导质量的关联进行分析,并分析患者出院准备度影响因素。结果 合并慢性疾病以及居住方式方面,不同亚组患者间出院准备度得分比较差异具有统计学意义(P<0.05);Pearson相关性分析显示出院准备度量表各维度得分与出院指导质量得分呈正相关(均P<0.05);Logistic回归分析显示,居住方式得分为出院准备度量表得分的独立影响因素(P<0.05)。结论 经皮肝穿刺胆道引流术恶性梗阻性黄疸患者出院准备度得分较低,通过改变患者居住方式、提高患者出院指导质量,将有助于提高患者出院准备度。
Objective To analyze the discharge readiness of patients with malignant obstructive jaundice after percutaneous transhepatic biliary drainage,and explore the influencing factors of discharge readiness of such patients.Methods A total of 80 patients with malignant obstructive jaundice who underwent percutaneous transhepatic biliary drainage in Tianjin People's Hospital from September 2020 to April 2023 were selected as the research objects.The data such as sex and age of the patients were statistically analyzed in the hospital system,and the discharge readiness scale was used to evaluate the discharge readiness of the patients.The discharge guidance quality scale was used to evaluate the discharge guidance quality of patients.Pearson correlation analysis was selected to analyze the relationship between the discharge readiness and the discharge guidance quality,analyze factors influencing patient discharge readiness.Results There was a statistically significant difference(P<0.05)in the comparison of discharge readiness scores between different subgroups of patients with combined chronic diseases and living habits.Pearson correlation analysis showed that the scores of each dimension of the discharge readiness measurement table were positively correlated with the scores of discharge guidance quality(all P<0.05).Logistic regression analysis showed that the residential style score was an independent influencing factor(P<0.05)for the discharge readiness scale score.Conclusions The discharge readiness score of patients with malignant obstructive jaundice undergoing percutaneous liver puncture biliary drainage was low.By changing the patient's living style and improving the quality of discharge guidance,will help to improve the patient's discharge readiness.
论著
目的 探讨乳腺癌术后疼痛综合征(PMPS)的发生率及影响因素。方法 选择2021年1月—2023年2月医院收治的82例乳腺癌患者为研究对象,采取手术治疗,统计PMPS发生率,分析PMPS的特征,比较PMPS患者和非PMPS患者的临床资料,采用 Logistic 逐步回归分析。结果 82例中有20例患者术后发生PMPS,发生率为24.39%,其中患侧腋窝45.00%、麻木样疼痛35.00%、中度疼痛60.00%、术后即刻疼痛50.00%、每日发作疼痛50.00%占比较高。PMPS患者和非PMPS患者的体质指数、教育程度、病理分期、肿瘤占位、手术方式、术前使用非甾体抗炎药、术前化学治疗、术后化学治疗比较差异均无统计学意义(P>0.05)。PMPS患者年龄低于非PMPS患者,负性情绪率30.00%高于非PMPS患者8.06%,清扫腋窝淋巴结率95.00%高于非PMPS患者72.58%,术后放射治疗率30.00%高于非PMPS患者6.45%(P<0.05)。年龄、负性情绪、清扫腋窝淋巴结、术后放射疗为PMPS发生的危险因素(P<0.05)。结论 乳腺癌术后较容易发生PMPS,主要表现为术后即刻腋窝疼痛、麻木,发作频率较高,疼痛较重,其中年龄小、术前焦虑、清扫腋窝淋巴结、术后放疗为引发PMPS的危险因素,需加强监测和针对性处理,研究价值较高。
Objective To investigate the incidence and influencing factors of post-mastectomy pain syndrome(PMPS)in breast cancer patients.Methods A total of 82 patients with breast cancer admitted to our hospital from January 2021 to February 2023 were selected as the research objects,and underwent surgical treatment.The incidence of PMPS was counted,the characteristics of PMPS were analyzed,and the clinical data of PMPS patients and non-PMPS patients were compared.Results Among the 82 patients,20 patients had PMPS after surgery,with an incidence of 24.39%.Among them,the affected axilla accounted for 45.00%,numbness pain 35.00%,moderate pain 60.00%,immediate postoperative pain 50.00%,and daily pain 50.00%.There were no significant differences in body mass index,education level,pathological stage of disease,tumor location,surgical method,preoperative use of non-steroid anti-inflammatory drugs,preoperative chemotherapy and postoperative chemotherapy between PMPS patients and non-PMPS patients(P>0.05).The age of PMPS patients was significantly higher than that of non-PMPS patients,the rate of negative emotion was 30.00%,the rate of axillary lymph node dissection was 95.00%,and the rate of postoperative radiotherapy was 30.00%,which was significantly higher than that of non-PMPS patients(P<0.05).Age,negative emotion,axillary lymph node dissection and postoperative radiotherapy were independent risk factors for PMPS(P<0.05).Conclusions PMPS is prone to occur after breast cancer surgery,mainly characterized by immediate postoperative axillary pain and numbness,with a high frequency and severe pain.Young age,preoperative anxiety,axillary lymph node dissection,and postoperative radiotherapy are independent risk factors for PMPS,which need to be strengthened monitoring and targeted treatment.
护理研究
目的 探讨风险防范护理干预对颅内动脉瘤介入术后患者血管并发症的应用。方法 选取天津市人民医院2020年6月—2023年10月收治的80例颅内动脉瘤患者,应用随机数字表法将其分为观察组与对照组,各40例。所有患者均采取血管内介入栓塞术治疗,对照组患者实施常规护理,观察组患者在对照组基础上增加风险防范护理干预。对比两组患者干预前后负面情绪变化、术后并发症发生率、干预前后生活质量变化以及护理满意度。结果 干预后,两组焦虑、抑郁评分降低,观察组分别为(39.78±1.80)(44.73±3.78)分,低于对照组的(54.63±3.91)(49.23±4.14)分,对比差异有统计学意义(t=21.823、5.078,P<0.05);观察组术后并发症发生率低于对照组(7.50% vs 27.50%,χ2=5.541,P=0.019);干预后两组中文版明尼苏达心功能不全生命质量(MLHFQ)相关维度评分均升高,且观察组分别为(30.73±3.82](21.13±2.70)(27.08±4.28)分,高于对照组的(26.20±3.50)(17.20±2.79)(23.20±2.35)分,对比差异有统计学意义(t=5.530、6.389、5.021,P<0.05);观察组护理满意度高于对照组(92.50% vs 72.50%,χ2=5.541,P=0.019)。结论 颅内动脉瘤介入术后采取风险防范护理干预可改善患者焦虑、抑郁情绪,降低术后并发症,改善患者术后生活质量,患者护理满意度较高。
Objective To investigate the application effect of risk prevention nursing intervention on vascular complications in patients with intracranial aneurysms after interventional surgery.Methods Eighty patients with intracranial aneurysm admitted in Tianjin People’s Hospital from June 2020 to October 2023 were selected and divided into observation group and control group with 40 cases each.All the patients were treated with endovascular interventional embolization,the control group patients underwent routine care,and the observation group patients added risk prevention nursing intervention on the basis of the control group.The negative mood changes before and after the intervention,the incidence of postoperative complications,the quality of life before and after the intervention,and nursing satisfaction were compared between the two groups.Results After the intervention,the anxiety and depression scores in both groups decreased,and the observation group[(39.78±1.80)and (44.73±3.78)] scores were lower than the control group[(54.63±3.91)and(49.23±4.14)] scores,significantly(t=21.823,5.078,P<0.05).The postoperative complication rate was significantly lower than the control group(7.50% vs 27.50%,χ2=5.541,P=0.019).After the intervention,MLHFQ related dimension scores were increased in both groups,and the observation group(30.73±3.82,21.13±2.70 and 27.08±4.28)scores were higher than the control group(26.20±2.50,17.20±2.79 and 23.20±2.35)scores,statistically significant(t=5.530,6.389,5.021,P<0.05).The nursing satisfaction was higher than the control group(92.50% vs 72.50%,χ2=5.541,P=0.019).Conclusion sRisk prevention nursing intervention after intracranial aneurysm intervention can improve patient anxiety and depression,assist in reducing the incidence of postoperative complications,improve patient quality of life,and increase patient satisfaction with nursing.
论著
目的 探讨术前血清肌酐(sCr)、估测肾小球滤过率(eGFR)对急性A型夹层术后急性肾损伤3级(AKI 3级)及连续性肾脏替代治疗(CRRT)的影响。方法 回顾性分析广州市第一人民医院2017年1月—2022年12月6年间收治的143例行Bentall或升主动脉置换+Sun’s手术的急性Stanford A型夹层患者术前sCr及eGFR、术后24 h及48 h sCr、尿量、术后AKI及CRRT情况。应用ROC曲线(受试者特征曲线)分析术前sCr、eGFR对术后AKI 3级及CRRT的影响。结果 术后AKI 3级27例(18.9%),CRRT 14例(9.8%)。发生AKI 3级及CRRT的患者术前sCr水平升高(AKI3级与AKI0-2级组间比较t’=-2.722,P=0.011,CRRT与非CRRT组间比较t’=-2.184,P=0.048)、eGFR降低(AKI3级与AKI0-2级组间比较t=4.585,P<0.001,CRRT与非CRRT组间比较t=4.932,P<0.001)。ROC曲线分析提示术前sCr可有效预测术后AKI 3级(AUC 0.768,临界点123 μmol/L,灵敏度67%,特异度85%)及CRRT(AUC 0.848,临界点137.5 μmol/L,灵敏度71%,特异度88%)。eGFR可预测AKI 3级[AUC 0.761,临界点56.25 mL/(min·1.73 m2),灵敏度67%,特异度83%]及CRRT[AUC 0.855,临界点47.6 mL/(min·1.73 m2),灵敏度71%,特异度87%]。手术合并低心排血量等肾灌注不良时,eGFR低于75.9 mL/(min·1.73 m2),术后CRRT发生率增加。结论 急性A型夹层术前sCr及eGFR影响术后AKI 3级及CRRT的发生。sCr>123 μmol/L、eGFR低于58.25 mL/(min·1.73 m2)的患者术后AKI 3级发生率增加。sCr>137.5 μmol/L、eGFR低于47.6 mL/(min·1.73 m2),或合并肾灌注不良的患者术后CRRT发生率增加。
Objective To explore the influences of preoperative serum creatinine(sCr)and estimated glomerular filtration rate(eGFR)on postoperative stage 3 acute kidney injury(AKI)or continuous renal replacement treatment(CRRT)in patients with acute Stanford type A aortic dissection(ATAAD).Methods From July 2017 to December 2022,143 ATAAD patients who underwent Bentall or ascending aortic replacement and total arch replacement and stented elephant trunk were retrospective analyzed.Data included preoperative sCr and eGFR,postoperative sCr,eGFR,urine volume,AKI and CRRT at 24 h and 48 h.Receiver operating characteristic(ROC)curve were used to analyze the influences of preoperative sCr and eGFR on stage 3 AKI and CRRT.Results Stage 3 AKI occurred in 27(18.9%)patients,including 14 patients who required CRRT.sCr was significantly higher in stage 3 AKI or CRRT group(AKI 3 vs AKI 0-2 group:t’=-2.722,P=0.011,CRRT vs non-CRRT group:t’=-2.184,P=0.048),and eGFR was significantly lower(AKI 3 vs AKI 0-2 group:t=4.585,P<0.001,CRRT vs non-CRRT group:t=4.932,P<0.001).Preoperative sCr could effectively predict postoperative stage 3 AKI(AUC 0.768,the best cut-off value was 123 μmol/L,sensitivity 67%,specificity 85%)and CRRT(AUC 0.848,the best cut-off value was 137.5 μmol/L,sensitivity 71%,specificity 88%).Preoperative eGFR could predict postoperative stage 3 AKI(AUC 0.761,the best cut-off value was 56.25mL/(min·1.73 m2),sensitivity 67%,specificity 83%)and CRRT(AUC 0.855,the best cut-off value was 47.6 mL/(min·1.73 m2),sensitivity 71%,specificity 87%).CRRT requirement significantly increased in patients with eGFR lower than 75.9 mL/(min·1.73 m2) who complicated with peripheral malperfusion.Conclusion sPreoperative sCr and eGFR have significant influences on incidence of postoperative stage 3 AKI and CRRT.Postoperative stage 3 AKI significantly increase in patients with sCr more than 123 μmol/L or eGFR lower than 56.25mL/(min·1.73 m2).Postoperative CRRT significantly increase in patients with sCr more than 137.5 μmol/L,eGFR lower than 47.6mL/(min·1.73 m2),or peripheral malperfusion.
临床诊疗
目的 探讨频发室性早搏与四级非心脏手术术后心衰发生率的相关性。方法 回顾性分析2020年7月—2021年6月于我院治疗的201例四级非心脏手术患者,根据术后是否发生心衰,将其分为心衰组和非心衰组,其中出现心衰者20例,未心衰者181例。分析2组患者临床资料、频发室性早搏次数,随后经单因素分析及Logistic回归分析术后心衰发生率的相关性。结果 心衰组临床资料中性别、糖尿病史、饮酒史、吸烟史、手术危险性分级、BMI、血红蛋白、红细胞宽度、左室舒张末径、左室射血分数值与非心衰组比较,差异无统计学意义(P>0.05);心衰组年龄大于非心衰组,胆固醇值、甘油三酯、室性早搏次数、术前肌酐水平均高于非心衰组(P<0.05);经多因素Logistic回归分析,分析结果显示年龄(OR=1.400,95%CI:1.060~1.848)、胆固醇值(OR=4.318,95%CI:1.122~16.622)、甘油三酯(OR=12.889,95%CI:1.232~134.808)、室性早搏次数(OR=1.010,95% CI:1.001~1.020)、术前肌酐(OR=34.071,95% CI:1.186~978.753)为四级非心脏手术术后发生心衰的危险因素(P<0.05)。结论 频发室性早搏为四级非心脏手术术后心衰发生的危险因素,其中年龄、胆固醇值、甘油三酯、术前肌酐也为术后心衰发生的危险因素。