急性脑卒中患者发生卒中相关性肺炎危险因素临床分析

目的探讨急性脑卒中患者发生卒中相关性肺炎(SAP)的危险因素,以降低SAP的发生率。方法收集2012年1月至2016年6月,在海南医学院第二附属医院神经内科就诊的380例急性脑卒中患者病例资料,根据是否发生卒中相关性肺炎(SAP)将其分为SAP组(69例)和非SAP组(311例),比较两组间差异,并分析SAP的相关危险因素。结果收集的380例急性脑卒中患者中,SAP的发生率为18.15%(69/380);单因素分析比较两组患者的临床特征,发现年龄≥65岁,意识障碍,吞咽困难,卧床,糖尿病,慢性支气管炎都是SAP发生的相关因素,差异有统计学意义(P0.05);OR值由高到低排序:意识障碍、吞咽困难、慢性支气管炎、糖尿病、年龄≥65岁、卧床;多因素非条件logistic回归分析,结果显示年龄≥65岁、意识障碍、吞咽困难、卧床、糖尿病、慢性支气管炎是急性脑卒中发生SAP的独立危险因素(P0.05)。结论 SAP的发生有很多相关危险因素,通过控制及改善急性脑卒中患者发生SAP的高危因素,采取积极正确的防治措施,可降低急性脑卒中患者患SAP的发生率,改善预后。

Clinical analysis in risk factors of stroke-associated pneumonia in patients with acute cerebral infraction

Objective To analyze the risk factors of stroke-associated pneumonia (SAP) in patients with acute cerebral infraction.For reducing the morbidity of SAP.Methods Collected case data of 380 inpatients with acute cerebral infraction in our department from January 2012 to June 2016.The patients were divided into two groups,69 patients complicated with SAP were served as case group,and 311 patients did not complicated with SAP were served as control group.To analyze the risk factors of SAP after comparing the differences of case data between the two groups.Results The morbidity of SAP was 18.15％ (69/380) in patients with acute cerebral infraction.Single factor analysis the clinical characteristics of two groups,the risk factors associated with SAP including age equal or over 65 years,disturbance of consciousness,dysphagia,lie in bed,diabetes mellitus,chronic bronchitis.The difference was statistically significant (P＜0.05).OR value from high to low order:disturbance of consciousness,dysphagia,chronic bronchitis,diabetes mellitus,age equal or over 65 years,lie in bed.Multivariate unconditional logistic regression analyses,the result showed above the reasons are independent risk factors for SAP.Conclusion There were many reliated risk factors causing SAP.To control and improve these factors,SAP in patient with acute cerebral infraction could be prevented or cured,and the morbidity would be reduced.