脑卒中患者医院内获得性肺炎危险因素分析

目的探讨脑卒中患者医院内获得性肺炎的危险因素及防治措施。方法对我院2003-01-01~2004-12-31 1832例脑卒中住院患者进行调查统计分析。结果医院内获得性肺炎感染率为5.57%,其中脑出血、脑梗死患者感染率分别为7.72%(24/311)和5.13%(78/1521)。Logistic多因素分析提示,发生医院内获得性肺炎OR的大小依次是预防应用抗生素、气管插管、气管切开、昏迷、应用H2受体阻滞剂、糖尿病、住院天数、吞咽困难、慢性阻塞性肺病(COPD)、鼻饲胃管。结论住院天数、气管切开、气管插管、鼻饲胃管、糖尿病、COPD、昏迷、吞咽困难、应用H2受体阻滞剂和预防应用抗生素等10个因素为脑卒中患者医院内获得性肺炎的相关危险因素。提示在临床工作中应予重视并加强防护,减少医院内获得性肺炎的发生。

Risk factors of nosocomial acquired pneumonia in the patients with apoplexy

Objective To explore the risk factors and preventive measures for nosocomial acquired pneumonia in the patients with apoplexy.Method A prospective and retrospective study was carried out to investigate the clinical data of 1832 patients with apoplexy during January 1st,2003 to December 31st,2004.Results The nosocomial acquired pneumonia rate was 5.57%.The nosocomial acquired pneumonia rate in the patients with cerebral hemorrhage and cerebral infarction was 7.72%(24/311)and 5.13%(78/1521) respectively.The risk factors were the application of antibiotics,tracheal intubation,tracheotomy,confusion,H_2-receptor blocking agents,duration of diabetes mellitus,the days of hospitalization,dysphagia,chronic obstructive pulmonary disease(COPD) and enteral nutrition infusion.Conclusions Nosocomial acquired pneumonia is closely related to ten factors: the days of hospitalization,tracheal intubation,tracheotomy,confusion,enteral nutrition infusion,duration of diabetes mellitus,dysphagia,COPD and the application of antibiotics and H_2-receptor blocking agents.The results suggest that we should pay attention to clinical treatment and nursing in order to lower the occurrence of the nosocomial acquired pneumonia.