老年急性脑梗死合并肺部感染患者的危险因素和预后相关性研究

目的探讨老年急性脑梗死合并肺部感染患者的危险因素及对预后的影响。方法选择老年急性脑梗死患者131例,根据是否合并肺部感染分为肺部感染组34例和对照组97例。分析肺部感染的危险因素和预后相关性。结果与对照组比较,肺部感染组患者年龄偏高,入院时美国国立卫生研究院脑卒中量表(NIHSS)评分、存在球麻痹症状和意识障碍比例明显增高,合并肺部疾病、心脏病明显增多(P<0.05,P<0.01)。脑梗死合并肺部感染的危险因素有年龄、肺部疾病、心脏病、球麻痹、意识障碍。肺部感染组患者住院时间较对照组明显延长,病情明显加重,病死率明显增高(P<0.01)。结论对于高龄、入院时NIHSS评分高、意识障碍、球麻痹、肺部疾病和心脏病的老年急性脑梗死患者应及早预防,已发生肺部感染的患者应当给予积极有效的治疗。

Study on correlation between risk factors and prognosis of pulmonary infection in elderly patients with acute cerebral infarction

Objective To investigate the risk factors and prognosis of pulmonary infection in elderly patients with acute cerebral infarction.Methods 131 elderly patients with cerebral infarction for half a year(Jan to Jun,2010) were selected.On the basis of whether pulmonary infection developed, they were divided into two groups:the pulmonary infection group(n = 34) and the control group(n=97).The correlation of risk factors with prognosis of pulmonary infection was analyzed. Results Compared with the control group,patients in pulmonary infection group were older, had higher NIHSS score,higher rates of bulbar paralysis,conscious disturbance,history of pulmonary disease and heart disease(P<0.05,P<0.01).The independent risk factors for pulmonary infection complication were age(OR = 1.133,95%CI:1.048 - 1.226,P<0.01),history of pulmonary disease(OR = 5.316,95%CI:1.106-25.549,P<0.05),history of heart disease (OR = 8.006,95%CI:2.566 - 24.981,P<0.01),conscious disturbance(OR = 7.290, 95%CI:1.812-29.327,P<0.01),and bulbar paralysis(OR = 5,017,95%CI:1.596 - 15.771,P<0.01).The hospital stay time of cerebral infarction complicated with pneumonia patients was significantly longer(P<0.01).Their conditions were apt to be aggravated and their fatality was significantly increased(P<0.01).Conclusion Elderly patients with cerebral infarction have high NIHSS score,bulbar paralysis,conscious disturbance,history of pulmonary disease or heart disease,should be given early prevention,active and effective treatment should be given to those who have pulmonary infections.