脑梗死患者肺部感染的临床治疗对预后的影响  

Clinical treatment of pulmonary infection in patients with cerebral infarction and impact on prognosis

作　　者：单彩云[1] 尚美玲[1] 吕素芹[1] 

机构地区：[1]潍坊市人民医院保健三科,山东潍坊261041

出　　处：《中华医院感染学杂志》2013年第19期4642-4644,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金(81170207)

摘　　要：目的探讨脑梗死合并肺部感染患者的感染因素、临床表现和预后,为临床减少肺部感染的发生、预防脑梗死合并肺部感染提供依据。方法采用回顾性调查的方法,将2011年1月-2012年12月收治的560例脑梗死患者分为肺部感染组105例和未感染组455例,对其相关因素、临床表现和预后等进行统计分析。结果肺部感染组平均年龄(72.4±9.7)岁,高于未感染组(67.2±8.3)岁;肺部感染组高脂血症病史62例,高于未感染组;肺部感染组意识障碍和住院天数分别为58例和(33.36±12.17)d,未感染组为98例和(25.71±10.35)d,差异均有统计学意义(P<0.05);肺部感染组发热、血白细胞升高、呼吸衰竭、休克和多器官衰竭分别为68、65、60、23和29例,与肺部未感染组比较,差异均有统计学意义(P<0.05);肺部感染组减少的脑卒中评分、巴氏指数评分和量表评分分别为(43.94±16.73)、(54.48±15.80)分和(2.94±1.17)分,与肺部未感染组比较差异有统计学意义(P<0.05);肺部感染组病死率40.95%,未感染组为10.55%,两者比较差异有统计学意义(P<0.05)。结论脑梗死合并肺部感染是多因素综合所致,肺部感染影响急性脑梗死患者的功能恢复和预后,应采取有效措施,降低脑梗死合并肺部感染率。OBJECTIVE To explore the factors, clirdcal manifestations and prognosis of cerebral infarction patients complicated with lung infections so as to provide the guidance for reducing the incidence of lung infections and preventing the pulmonary infections in the cerebral infarction patients. METHODS By retrospective survey study, 560 patients with cerebral infarction were selected from Jan 2011 to Dec 2012 in the hospital and were divided into lung infection group （n=105） and non-infection group （n=455）. It was analyzed statistically including infection factors, clinical manifestations and prognosis. RESULTS The average age of the lung infection group was （72.4 ±9.7）, higher than （67.2±8.3） of the non-infection group （P〈0.05）. The incidence of hyperlipidemia of the lung infection group（59.04%62/105）was higher than the non-infected group （P〈0.05）. The rate of conscious disturbance and hospitalization time of lung infection group and the non-infection group were 55.23~ （58/105）, （33.36~ 12.17） days and 21. 53% （98/455）, （25. 71 ± 10. 35） days respectively, with statistically significant differences （P〈0.05）. In lung infection group, the cases of fever, increasing white blood cells, respiratory failure, shock and multiple organ failure were 68, 65, 60, 23 and 29 respectively, with significant difference （P〈0.05） compared with non-infection group. Decreased NIHSSM, BI and mRS scores in lung infection group were（43.94±16.73） ,（54.48±15.80）and（2.94±1.17）points respectively, with significant difference（P〈0.05） compared with non-infection group. There was significant difference in the mortality between the lung infection group （40. 95%） and the non-infected group （10. 55%）（P 〈 0. 05）. CONCLUSION The cerebral infarction combined with pulmonary infection is caused by multiple factors, and it affects functional recovery and prognosis of patients with acute cerebral infarction. Effective measures should be taken to reduce the i

关 键 词：脑梗死 肺部感染 临床观察 预后 

分 类 号：R563.1[医药卫生—呼吸系统]