脑卒中后肺部感染相关因素分析及其对患者短期预后的影响  

Risk factors of stroke-associated pneumonia and influence on short-term prognosis of patients

作　　者：刘文帅[1] 

机构地区：[1]德州市人民医院急诊科,山东德州253014

出　　处：《临床荟萃》2014年第11期1233-1236,共4页Clinical Focus

摘　　要：目的探讨脑卒中后肺部感染相关危险因素及其对患者短期预后的影响。方法对510例急性脑卒中患者进行分析,根据是否合并肺炎分为肺部感染组(n=126)与非肺部感染组(n=384),分别观察两组病例的慢性肺疾病史、吸烟史、卧床时间、糖尿病史;意识水平、吞咽功能,脑卒中部位、性质、面积;入院时及入院4周分别进行临床神经功能缺损程度评分,院内病死率等各项指标,进行统计学分析。结果肺部感染组有吸烟史、肺部慢性疾病史、糖尿病、长时间卧床、大面积脑梗死、大量脑出血、吞咽功能障碍及意识障碍者较非肺部感染组明显增多(P<0.05);肺部感染组四周时神经功能缺损评分显著高于非肺感染组(P<0.05);肺部感染组的病死率显著高于非肺部感染组(P<0.05)。结论脑卒中患者发生肺部感染的相关危险因素有吸烟史、肺部慢性疾病史、糖尿病、长时间卧床、大面积脑梗死、大量脑出血、吞咽功能障碍、伴有意识障碍;脑卒中肺部感染患者的近期神经功能预后差、病死率高。Objective To investigate the risk factors of stroke-associated pneumonia（SAP）,and influence on short-term prognosis of patients.Methods According to whether patients had pulmonary inflammation,5 10 cases of acute stroke patients were divided into lung infection group（n =126）and non-lung infection group（n =384）.Chronic lung disease history,smoking history,bed time,diabetes history,consciousness level,swallow function,stroke, stroke position in nature,stroke area,neural function defect degree score,disease death rate of two groups were observed.Results Smoking history,chronic lung disease,diabetes mellitus,lying in bed for a long time,large area cerebral infarction,massive cerebral hemorrhage,swallow dysfunction,conscious disturbance of lung infection group were more common than those in non-infection group（P 〈0.05）.Neural function defect degree score of lung infection group was higher than that of non-infection group （P 〈 0.05 ）.Disease death rate of lung infection group was significantly higher than that of non lung infection group （P 〈 0.05 ）.Conclusion The risk factors of SAP are smoking history,chronic lung disease,diabetes mellitus,lying in bed for a long time,large area cerebral infarction, massive cerebral hemorrhage,swallow dysfunction,conscious disturbance.The SAP patients have poor short-time prognosis of neurological function and higher hospital mortality.

关 键 词：脑血管意外 肺炎 危险因素 预后 

分 类 号：R743.1[医药卫生—神经病学与精神病学]