急性脑梗死患者并发医院获得性肺炎危险因素分析

目的探讨脑梗死患者并发医院获得性肺炎的危险因素。方法收集2001年1月～2009年12月脑梗死患者资料485例,根据是否并发医院获得性肺炎,分为获得性肺炎组与非获得性肺炎组,比较两组患者间年龄、性别、身体质量指数（BMI）、住院日、意识障碍程度和时间、吸烟、饮酒、慢性基础病（糖尿病、肺部疾病、心脏病）,医院获得性肺炎发生前进行的侵袭性操作（如气管插管、气管切开、呼吸机的使用、鼻饲胃管）与糖皮质激素的应用等因素的差异性,并进行Logistic回归多因素分析。结果 75例（15.5%）患者并发医院获得性肺炎,两组比较结果显示,年龄、吸烟史、肺部基础病、糖尿病、意识障碍程度、住院时间、气管插管、气管切开、呼吸机的使用等8个因素差异有统计学意义;多因素分析结果显示：意识障碍时间、肺部基础疾病、糖尿病、住院时间、气管切开等5个因素与脑梗死后并发医院获得性肺炎有关。结论肺部基础疾病、糖尿病、意识障碍时间、住院时间、气管切开均是脑梗死后并发医院获得性肺炎发生的危险因素。

Risk factors analysis of hospital-acquired pneumonia after the patients of acute cerebral infarction

Objective To investigate the risk factors of hospital-acquired pneumonia after the patients of acute cerebral infarction.Methods 485 cases patients of cerebral infarction from January 2001 to December 2009 were allocated into acquired pneumonia group and non-acquired pneumonia group depending on whether concurrent hospital acquired pneumonia.Different factors in the two groups were compared about age,sex,body mass index （BMI）,hospitalization time,level and time of consciousness,smoking,alcohol consumption,chronic underlying diseases including diabetes,lung disease and heart disease,the invasive operation such as tracheal intubation,traeheotomy,the use of ventilator,Nasal feeding and stomach tube,etc and the application of hormone,and make Logistic regression analysis.Results 75 cases （15.5 percent） patients infected with hospital-acquired pneumonia.The two groups showed that the eight factors of age,smoking history,lung underlying diseases,diabetes,level of consciousness,hospitalization time,tracheal intubation,tracheotomy,tracheotomy,the use of ventilator were significant.Multi-factor analysis showed that the five factors of the time of consciousness,pulmonary underlying disease,diabetes,hospitalization time,tracheotomy were correlated with hospital-acquired pneumonia.Conclusion Pulmonary underlying diseases,diabetes,disturbance of consciousness,hospitalization time,tracheotomy were risk factors of hospital-acquired pneumonia after acute cerebral infarction.