急性脑卒中并发肺部感染相关因素及病原学分析

目的 探讨急性脑卒中患者合并肺部感染的危险因素及病原学特点.方法 回顾性分析257例急性脑卒中患者的临床资料,其中并发肺部感染65例的发生率及其与病情轻重、意识障碍、卒中类型、基础疾病、侵入性检查的关系以及肺部感染病原菌及药敏情况.结果 急性脑卒中患者合并肺部感染发病率高(25.29%,65/257),与患者病情轻重(轻、中度组相比较,x2=11.81,P＜0.01;中、重度组相比较,x2=23.53,P＜0.01)、意识障碍(有、无意识障碍相比,x2=41.09,P＜0.01)、基础痰病等多种因素有关.病原菌以G-杆菌为主,亚胺培南对G-、G+菌敏感率最高.结论 急性脑卒中合并肺部感染是多种因素的结果,感染以G-杆菌为主,根据以上特点治疗急性脑卒中预防肺部感染有临床指导意义.

Risk factors and pathogenesis analysis in pulmonary infection complicated to acute stroke patients.

Objective To study the risk factors and pathogenesis of pulmonary infection in acute stroke patients. Methods A retrospective analysis was taken in 257 acute stroke cases to investigate the incidence of pulmonary infection and its relationship with the underlying disease, disturbance of consciousness, invasive operation,the type of pathogenic bacteria and drug susceptibility. Results The positive rate of pulmonary infection in acute stroke patients was high and related to many factors including severity of stroke, disturbance of consciousness,primary diseases, and invasive examination etc. The most popular infective bacteria were Gram-negative bacteria. The imipenem was most sensitive to Gram-negative and Gram-positive bacteria, followed by Amikacin and piperacillin too. Conclusions The pulmonary infection in cerebral stroke patients is caused by many factors, of which Gramnegative bacteria play the most important role. Identification of the risk factor and pathogenic bacteria is helpful in treating cerebral stroke infectious complications.