急性脑卒中合并肺部感染相关因素及对预后的影响

目的 探讨急性脑卒中患者并发肺部感染的相关因素及其对患者预后的影响.方法 回顾性分析医院185例急性脑卒中患者的临床资料,对可能影响患者并发肺部感染的相关因素进行分析,并分析肺部感染对患者预后的影响.结果 急性脑卒中并发肺部感染与年龄、卒中类型、患者有意识障碍及吞咽困难、卧床时间、接受侵入性操作、基础疾病以及肺部感染前应用过广谱抗菌药物密切相关,差异均有统计学意义(均P＜0.05)；logistic回归结果发现:合并基础疾病、卒中类型、有侵入性操作是影响肺部感染发生的独立危险因素；急性脑卒中并发肺部感染组出院时美国国立卫生研究所脑卒中评分(NIHSS)减少(13.82±1.62)％,无肺部感染组减少(58.26±2.72)％；并发肺部感染组病死率为24.1％,无肺部感染组病死率为7.6％,两组比较差异有统计学意义(P＜0.01).结论 合并基础疾病、卒中类型、有侵入性操作治疗是影响急性脑卒中患者发生肺部感染的独立危险因素,肺部感染影响急性脑卒中患者的功能恢复和预后.

Risk factors for pulmonary infections in patients with acute cerebral apoplexy and influence on prognosis

OBJECTIVE To study the related factors for pulmonary infections in acute cerebral apoplectic patients and the influence on prognosis.METHODS The clinical data of 185 acute cerebral apoplectic patients were retrospectively analyzed.The related factors for the concurrent pulmonary infections and the influence on the prognosis were analyzed.RESULTS The incidence of pulmonary infections combined with acute cerebral apoplexy was closely associated with the age,the nature of stroke,consciousness,dysphagia,bed-time,invasive operation,underlying disease and the use of broad spectrum antibiotics,the differences were statistically significant(P<0.05);logistic regression analysis demonstrated that the underlying diseases,the nature of stroke,and the invasive operation were the independent risk factors for pulmonary infections;there was an decrease of(13.82±1.62)% of NIHSS of the patients with pulmonary infection as they were discharged,the decrease of(58.26±2.72)% of the patients without pulmonary infections,and the death rate of the patients with pulmonary infections was 24.1%,higher than 7.6% of the patients without pulmonary infections,the differences were statistically significant(P<0.01).CONCLUSION The combined underlying disease,the nature of stroke,and invasive operation are the independent risk factors for the pulmonary infections in the patients with acute cerebral apoplexy;pulmonary infections in acute cerebral apoplectic patients can influence the recovery and prognosis.