急性脑卒中合并医院获得性肺炎的危险因素及预后分析  

Analysis of the risk factors and prognosis of patients with acute stroke combined with hospital acquired pneumonia

作　　者：段丽军[1] 曹秋梅[1] 马炳辰[2] 朱静[3] 

机构地区：[1]首都医科大学附属北京同仁医院南区急诊科,北京100176 [2]首都医科大学附属北京同仁医院综合内科,北京100176 [3]首都医科大学附属北京同仁医院神经内科,北京100176

出　　处：《中国实用神经疾病杂志》2014年第11期29-31,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨急性脑卒中合并医院获得性肺炎(HAP)的危险因素及对患者预后的影响。方法回顾性分析2011-09—2013-02在我院就诊的120例急性脑卒中患者的临床资料。评估脑卒中后发生肺炎的危险因素,包括年龄、性别、脑卒中类型、糖尿病史、高血压史、有无预防性应用抗生素和机械通气等情况。比较合并HAP组与未合并HAP组的预后。结果急性脑卒中合并医院获得性肺炎的发病率19.17%。医院获得性肺炎与年龄、糖尿病史、预防性应用抗生素、机械通气等因素相关,多因素分析结果显示,这些因素是HAP的独立危险因素。HAP组NIHSS评分、并发症发生率及病死率显著高于对照组,ADL评分显著低于非HAP组、住院时间显著长于非HAP组(P<0.05)。结论急性脑卒中合并医院获得性肺炎患者的预后差,危险因素有年龄、糖尿病史、预防性应用抗生素、机械通气等。Objective To explore the risk factors and prognosis of patients with acute stroke combined with hospital acquired pneumonia （HAP）.Methods The clinical data of 120 patients with acute stroke from September 2011 to February 2013 in our hospital was taken for retrospective analysis.The risk factors of HAP after acute stroke were assessed ,including age , gender ,type of stroke ,diabetes ,hypertension ,prophylactic antibiotics and mechanical ventilation.The differences in prognosis of AS patients with HAP group and non-HAP group were compared. Results The incidence rate of AS combined with HAP was 19.17%.HAP was associated with age ,diabetes ,prophylactic antibiotics ,and mechanical ventilation. Multivariate analysis showed that these factors were independent risk factors for HAP.And the NIHSS score ,morbidity and mortality rates of HAP group were significantly higher than those of non-HAP group ,ADL scores were significantly lower than that of the non-HAP group ,hospital stay was significantly longer than that of non-HAP group , P〈0.05.Conclusion Acute stroke patients combined with hospital acquired pneumonia has poor prognosis ,and the age ,diabetes ,prophylactic antibiotics ,mechanical ventilation are the related risk factors.

关 键 词：急性脑卒中 医院获得性肺炎 危险因素 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]