脑卒中气管切开患者肺部感染的危险因素分析  

Analysis of risk factors of pulmonary infections in stroke coma patients treated with tracheotomy

作　　者：何宏[1] 纪晓军[2] 韩春华[1] 

机构地区：[1]青岛大学附属医院检验科,山东青岛266003 [2]青岛大学附属医院急诊神经科,山东青岛266003

出　　处：《中华医院感染学杂志》2015年第8期1787-1789,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81373001)

摘　　要：目的分析脑卒中昏迷患者气管切开并发肺部感染的危险因素,为临床预防治疗工作提供参考依据。方法将2011年1月-2012年12月收治的脑卒中昏迷患者620例纳入研究,均给予气管切开、呼吸机辅助呼吸,观察肺部感染、分析病原菌种类,调查相关危险因素,采用SPSS 18.0软件进行统计分析。结果共发生肺部感染80例,感染率12.9%;检出病原菌122株,以革兰阴性菌为主,共84株占68.9%;年龄、糖尿病史、血清白蛋白、气管切开时间、抗菌药物使用、长期吸烟史、卧床时间是肺部感染的危险因素(P<0.05)。结论革兰阴性菌是导致脑卒中昏迷患者气管切开并发肺部感染的主要菌群,高龄、糖尿病、低蛋白血症、气管切开时间过长、滥用抗菌药物、吸烟史以及长时间卧床是肺部感染的危险因素,在临床工作中需加以重视和预防。OBJECTIVE To analyze the risk factors of pulmonary infections in stroke coma patients treated with tracheotomy and provide reference for clinical treatment.METHODS Totally 620 cases of stroke coma patients from Jan.2011 to Dec.2012 were enrolled and treated with tracheotomy and ventilator assisted breathing.Then pulmonary infections were observed,pathogens were detected and correlated risk factors were analyzed.The software SPSS18.0was used for statistical analysis.RESULTS There were 80 cases of pulmonary infections and the infection rate was 12.9%.There were 122 strains of pathogenic bacteria,mainly including 84 strains of gram negative bacteria（68.9%）.The risk factors of pulmonary infections were age,diabetes history,serum albumin,tracheotomy time,antibiotic use,long-term smoking history,and bedding time（P〈0.05）.CONCLUSIONGramnegative bacteria are the major pathogenic bacteria of stroke coma patients treated with tracheotomy.Advanced age,diabetes,hypoproteinemia,long time tracheotomy,abuse of antibiotics,smoking history and long time in bed are risk factors of pulmonary infections which need attention and prevention.

关 键 词：脑卒中 气管切开 肺部感染 危险因素 

分 类 号：R563.1[医药卫生—呼吸系统]