重症脑卒中患者肺部感染的危险因素分析  

Analysis of risk factors for pneumonia in critically ill patients with stroke

作　　者：高晗清[1] 罗玉敏[2] 

机构地区：[1]苏州大学附属第一医院神经内科,江苏苏州215006 [2]首都医科大学宣武医院神经内科,北京100053

出　　处：《中国医药导报》2012年第36期70-71,74,共3页China Medical Herald

基　　金：国家自然科学基金(81071058)

摘　　要：目的探讨重症脑卒中患者肺部感染的发生率及其危险因素。方法回顾性分析2010年10月-2012年5月入住神经内科重症监护室（NICU）的重症脑卒中患者148例，根据罹患肺部感染与否分为卒中相关性肺炎组与无卒中相关性肺炎组．分析重症脑卒中患者肺部感染的发生率及危险因素。结果重症脑卒中患者中99例并发了卒中相关性肺炎．发生率为66．9％。重症脑卒中患者罹患肺部感染与格拉斯哥昏迷评分（GCS）〈9分、鼻饲、抑酸药物的使用及机械通气密切相关。Logistic回归分析显示，GCS〈9分及抑酸药物的使用与卒中相关性肺炎独立相关。结论GCS〈9分、鼻饲、抑酸药物的使用及机械通气是重症脑卒中患者罹患肺部感染的危险因素，其中GCS〈9分及使用抑酸药物是其独立危险因素。Objective To determine the incidence and risk factors of pneumonia in critically ill patient with stroke. Meth- ods Clinical data in critically ill patients with stroke who were admitted to N!CU from October 2010 to May 2012 was col- lected retrospectively. All the patients were divided into pneumonia group （SAP group） and non-pneumonia group （no SAP group）. The incidence and risk factors of pneumonia in critically ill patient with stroke were analyzed. Results Among criti- cally ill patients with stroke, 99 patients met the study pneumonia criteria, the incidence of inpatients of neurological in- tensive care unit was 66.9%. Subjects who developed pneumonia had higher proportion in terms of GCS〈9, nasal feeding, antacid drugs, and application of mechanical ventilation. Logistic regression analysis showed that GCS〈9 and antacid drugs were the independent risk factors for stroke associated pheumonia. Conclusion Pneumonia in critically ill patient with stroke is associated with GCS 〈9, nasal feeding, antacid drugs, and application of mechanical ventilation. GCS 〈9 and antacid drugs are independent risk factors for pneumonia.

关 键 词：脑卒中 肺部感染 危险因素 

分 类 号：R743[医药卫生—神经病学与精神病学]