老年脑卒中患者相关性肺炎的危险因素分析

目的：探讨老年脑卒中患者相关性肺炎（SAP）的危险因素。方法回顾性分析2010年1月至2012年6月我院收治，年龄在60岁至89岁老年急性脑卒中患者223例的病历资料，其中SAP患者45例，无SAP患者178例，分析卒中相关性肺炎的发生率、危险因素。结果卒中相关性肺炎发生率为20.2%，其中53.3%为早发性肺炎，肺炎组死亡14例（31.1%），无肺炎组死亡10例（5.6%），肺炎组病死率明显高于无肺炎组（P＜0.05），Logistic回归分析显示≥80岁、吸烟、NIHSS≥11分、糖尿病、吞咽障碍、鼻胃管鼻饲、辅助机械通气、预防性使用抗生素、长期卧床是卒中相关性肺炎危险因素（P＜0.05）。结论卒中相关性肺炎是老年脑卒中患者严重并发症之一，直接导致病死率增加，临床医师应高度重视、积极预防，降低卒中相关性肺炎发生率、病死率。

Risk Factors of Stroke-Associated Pneumonia in Elderly Patients

Objective To investigate the risk factor of stroke-associated pneumonia （SAP）in elderly patients. Method Retrospectively analyzed clinical data of 223 patients（age 60 to 89）of our hospital with acute stroke between January 2010 to Jun 2012. SAP of 45 cases, non-pneumonia of 178 cases, SAP incidence and risk factors were analyzed. Results SAP incidence was 20.2%,early-onset pneumonia of 53.3%, dead of 14 cases（31.1%） in SAP group, dead of 10 cases （5.6%） in non-SAP group. Mortality rate of SAP group was signiifcantly higher than non-SAP group（P〈0.05）, according to Logistic regression analysis,≥80 years, smoking, NIHSS≥11, diabetes, impaired swallowing, catheterized nasal feeding, auxiliary mechanical ventilation, the use of prophylactic antibiotics and prolonged bed rest were independent risk factors（P〈0.05）.Conclusion SAP is one of the serious complications in elderly stroke patients. It is a direct result to increase mortality. In order to reduce SAP incidence and mortality, clinicians should attaches great importance and prevent actively.