颈部脊髓损伤急性期肺部感染危险因素

 目的 探讨颈部脊髓损伤（CSCI）急性期肺部感染的危险因素。方法 回顾性分析108例CSCI患者（C1~C8脊髓损伤）的临床资料，根据发病后1个月内是否发生肺部感染，分为肺部感染组和非肺部感染组。分析两组患者的基本情况、受伤形式、相关实验室检查等相关资料。结果 108例患者中，55例发生肺部感染，肺部感染发生率为50.9%。单因素分析发现，低血红蛋白水平、ASIA分级、低钠血症、呼吸机辅助通气可能是CSCI患者发生肺部感染的影响因素（均P<0.05）。多因素logistic回归分析结果显示，ASIA分级（OR＝0.399，95%CI：0.227~0.702，P＝0.001）、呼吸机辅助通气（OR＝77.564，95%CI：8.587~700.595，P<0.001）、血清钠离子水平（OR＝0.839，95%CI：0.735~0.958，P=0.009）为CSCI患者肺部感染的危险因素。结论 对于CSCI患者，ASIA分级A或B级、使用呼吸机辅助通气，以及低钠血症是肺部感染的独立危险因素。

Risk factors for pulmonary infection in acute stage of cervical spinal cord injury

Objective To explore the risk factors for pulmonary infection (PI) in acute stage of cervical spinal cord injury (CSCI). Methods Clinical data of 108 patients with CSCI (C1-C8 spinal cord injury) were analyzed retrospectively, according to whether PI occurred within 1 month after disease onset, patients were divided into PI group and non-PI group. Basic condition, injury type and relevant laboratory examination of two groups of patients were analyzed. Results Of 108 patients, 55 had PI, incidence of PI was 50.9%. Univariate analysis showed that low hemoglobin level, ASIA grade, hyponatremia and ventilator-assisted ventilation may be the influencing factors for PI in patients with CSCI (all P<0.05). Multivariate logistic regression analysis showed that ASIA grade (OR=0.399, 95%CI:0.227-0.702, P=0.001), ventilator-assisted ventilation (OR=77.564, 95%CI:8.587-700.595, P<0.001), and serum sodium ion level (OR=0.839, 95%CI:0.735-0.958, P=0.009) were risk factors for PI in patients with CSCI. Conclusion ASIA grade A or B, ventilator-assisted ventilation and hyponatremia are independent risk factors for PI in patients with CSCI.