急性卒中合并医院获得性肺部感染相关因素分析及预防

目的 探讨急性卒中合并医院获得性肺部感染的危险因素及预防.方法 对881例急性卒中住院患者的临床资料进行回顾性分析.结果 急性卒中患者881例,合并肺部感染者131例,感染率为14.9％（131/881）.病原菌以革兰阴性杆菌为主,占66.2％（98/148）;卒中类型、卒中史、糖尿病及侵入性操作与肺部感染的发生有关（P＜0.05）,年龄、住院时间、意识障碍、吞咽障碍、慢性肺部疾病史、低白蛋白血症以及肾功能不全与肺部感染的发生显著相关（P＜0.01）.合并肺部感染患者病死率为8.4％（11/131）,明显高于未合并肺部感染患者的1.6％（12/750）,差异有统计学意义（P＜0.01）.结论 急性卒中患者肺部感染与多种因素相互作用有关,并影响其预后.

Analysis of the correlative risk factors of hospital acquired pulmonary infection in patients with acute stroke and its prevention

Objective To investigate the correlative risk factors in patients with acute stroke complicated with hospital acquired pulmonary infection.Methods Clinical data of 881 cases with acute stroke were analyzed retrospectively.Results The incidence of complicating pulmonary infection was 14.9% （131/881）.The main pathogens were gram-negatives（66.2%,98/148）.Type of stroke,past history of stroke,diabetes,and invasive operation were correlated with the incidence of pulmonary infection （P 〈 0.05）.Age,hospital stay,conscious disturbance,dysphagia,chronic pulmonary disease,lower level of serum albumin,and renal failure was significantly correlated with the incidence of the pulmonary infection （P 〈 0.01）.The mortality in pulmonary infection cases was significantly higher than that in non-pulmonary infection cases[8.4 %（11/131） vs.1.6%（12/750）]（P〈 0.01）.Conclusion Pulmonary infection in patients with acute stroke is caused by many risk factors,and the prognosis is affected significantly.