老年重症脑梗死发生肺部感染的相关因素及治疗

目的研究老年重症脑梗死发生肺部感染的相关因素及治疗效果。方法将2011年1月至2013年12月期间我院收治的老年重症脑梗死患者720例作为研究对象，观察肺部感染情况并分析危险因素。结果①共发生肺部感染90例，肺部感染发生率为12．50％；②不同年龄、有创操作、糖尿病史、气道慢性疾病史、血浆白蛋白水平、广谱抗生素使用情况、糖皮质激素使用情况、吸烟史患者肺部感染的发生率有差异；③高龄、有创操作、糖尿病史、气道慢性疾病史、低蛋白血症、应用广谱抗生素、应用糖皮质激素、长期吸烟史是脑梗死患者发生肺部感染的危险因素（OR值分别为2．885、3．611、3．284、2．592、3．705、3．186、2．904、2．862，P值均〈0．05）；④根据药敏结果给予抗生素治疗，患者肺部感染均得到有效控制，胸片征象消失时间为（6．34±0．75）d，肺部哕音消失时间为（4．85±0．65）d。结论老年重症脑梗死发生肺部感染与年龄、有创操作、糖尿病史、气道慢性疾病史、低蛋白血症、应用广谱抗生素和糖皮质激素、长期吸烟史密切相关，根据药敏结果给予抗生素治疗能够取得积极疗效。

Related factors of pulmonary infection in elderly patients with severe cerebral infarction and its treatment

Objective To study related factors of pulmonary infection in elderly patients with severe cerebral infarction and its treatment effect. Methods 720 cases elderly patients with severe cerebral infarction in our hospital from January 2011 to December 2013 were enrolled and pulmonary infection was observed,correlated risk factors were analyzed. Results ①92 cases had pulmonary infection,the infection rate was 12.50%. ②There were statistical significance in the incidence of pulmonary infection among patients with different age, invasive operation, diabetes history, chronic airway disease history, serum albumin,antibiotic and glucocorticoid use situation, long-term smoking history. ③The old age, invasive operation, diabetes history, chronic airway disease history, hypoproteinemia, application of broad-spectrum antibiotics and glucocorticoid,long-term smoking history were risk factors of pulmonary infection （ OR = 2. 885,3. 611,3. 284,2. 592,3. 705,3. 186,2. 904,2. 862, respectively, all P 〈0.05）.④According to the results of drug susceptibility, patients were given antibiotics therapy, pulmonary infection was effectively controlled. The disappear time of chest X ray signs was （6.34±0.75） d,the disappear time of pulmonary rales was （4.85±0.65） d. Conclusions The pulmonary infection in elderly patients with severe cerebral infarction is closely related with age, invasive operation, diabetes history, chronic airway disease history, hypoproteinemia, application of broad-spectrum antibiotics and glucocorticoid,long-term smoking history. The antibiotic treatment according to the results of drug sensitivity can achieve positive effect.