老年卒中相关性肺炎临床特点、危险因素及病原菌分析  

Analysis of clinical characteristics,risk factors and pathogens of gerontal stroke associated pneumonia

作　　者：何娅[1] 秦章辉[1] 陈松盛[1] 王辉[1] 杨颖[1] 

机构地区：[1]西安交通大学医学院第二附属医院干一科,西安710004

出　　处：《陕西医学杂志》2013年第10期1362-1364,共3页Shaanxi Medical Journal

摘　　要：目的:探讨老年卒中相关性肺炎(SAP)的临床特点、危险因素、病原菌分布。方法:回顾性分析680例老年卒中患者的临床资料,根据是否发生肺炎分成感染组、非感染组,比较两组患者神经功能评分、病死率、危险因素,并分析痰细菌学。结果:680例老年卒中患者发生SAP 98例,感染组患者神经功能评分和病死率分别为32.50±1.38和20.03%,非感染组为25.80±1.13和6.85%(P<0.05);年龄大于70岁、吞咽障碍、意识障碍、卧床、基础疾病均为SAP的危险因素;痰细菌学检查以革兰阴性杆菌为主,占69.48%,多为大肠埃希菌、铜绿单胞菌和肺炎克雷伯菌;其次为革兰阳性球菌占22.03%,多为金黄色葡萄球菌、表皮葡萄球菌。结论:老年SAP危险因素多、临床预后差,病死率较高。早期预防、合理治疗,能改善老年卒中患者的预后,提高生活质量。Objective：To investigate the clinical characteristics, risk factors , pathogens and distribution of pathogens of gerontal stroke-associated pneumonia. Methods： We did a retrospective analysis of the clinical data of 680 cases of elderly stroke patients in our hospital, divided them into infection group and non infection group accord ing to whether the occurrence of pneumonia. Then we compared two groups of patients with neurological function score, mortality rate and risk factors, and analysed the two groups＇ sputum bacteriology respectively. Results： 680 cases of elderly stroke patients with SAP occurred in 98 cases. The neurological function scores and mortality rate were 32.50±1.38 and 20.03% in infection group, compared with 25.80±1.13 and 6.85%（P〈0.05） respectively in non-infection group. The risk factors of SAP analysis indicated that older than 70 years, dysphagia, consciousness disorder, long term bed, underlying diseases were risk factors for SAP. Sputum bacteriological examination showed that Gram staining negative bacilli accounted for 69.48%, Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae were in the majority; Gram-staining positive cocci accounted for 22. 03%, Staphylococcus aureus and Staphylococcus epidermidis were in the majority. Conclusion：Gerontal stroke associated pneumonia got varied risk factors, poor prognosis, and high mortality rate. Early prevention and appropriate treatment may improve the prog- nosis and the quality of life for elderly stroke patients.

关 键 词：卒中 肺炎 危险因素 死亡率 病原 

分 类 号：R378[医药卫生—病原生物学]