急性重症脑血管病患者卒中相关性肺炎的危险因素分析  

Risk factors of stroke-associated pneumonia in severe acute cerebrovascular disease

作　　者：赵红[1] 王宇[1] 丁宁[1] 张敬[1] 

机构地区：[1]首都医科大学附属北京同仁医院急诊科,北京100730

出　　处：《山西医科大学学报》2016年第2期146-149,共4页Journal of Shanxi Medical University

摘　　要：目的探讨急诊重症监护病房（EICU）重症脑血管病患者卒中相关性肺炎（SAP）的危险因素,为SAP防治提供科学依据。方法回顾性收集2013-06~2015-06急性期重症脑血管病（CVD）患者102例。所有患者均于入院后24 h内抽取空腹静脉血测定白细胞计数（WBC）、血糖和白蛋白水平。详细记录患者既往史（包括冠心病、高血压、糖尿病、COPD）、吸烟史、吞咽障碍、机械通气、留置胃管、深静脉置管。以患者出院时存活或死亡作为临床预后的终点评价指标。结果重症CVD患者SAP的发病率为72.5%,其中脑出血组SAP发病率为77.5%,脑梗死组SAP发病率为70.2%,梗死后出血组SAP发病率为60.0%,脑出血组SAP发生率明显高于脑梗死组,差异有统计学意义（P〈0.05）。高龄、卒中类型、冠心病、糖尿病、COPD、吸烟史、WBC升高、空腹血糖升高、低蛋白血症、吞咽障碍、机械通气、留置胃管、深静脉置管与SAP发病有关,在不同性别和是否高血压患者间差异无统计学意义。结论 SAP是由多种因素共同作用所致,应针对不同危险因素采取相应有效的预防控制措施,尽可能预防SAP发生。Objective To explore risk factors of severe acute stroke-associated pneumonia（ SAP） in emergency intensive care unit（ EICU） and provide a scientific basis for the prevention and clinical treatment of SAP. Methods A retrospective study was designed to analyze the clinical information of 102 cases of severe acute cerebrovascular disease（ CVD） admitted to hospital from June 2013 to June 2015. White blood count,fasting glucose and serum albumin levels were recorded on admission within 24 h. The disease history,smoking,dysphagia,mechanical ventilation,indwelling gastric tube and deep vein intubation were recorded. The clinical prognosis was evaluated with survival or death as the end index out of the hospital. Results Overall morbidity of SAP was 72. 5%. The incidence of SAP was 70. 2% for the patients with cerebral infarction,60. 0% for patients with cerebral hemorrhage after infarction,and 77. 5% for the patients with cerebral hemorrhage. The morbidity of SAP was higher in the patients with cerebral hemorrhage than in patients with cerebral infarction（ P〈0.05）. The incidence of SAP was related to age,type of stroke,coronary heart disease,diabetes mellitus,chronic obstructive pulmonary disease,smoking,increased WBC,increased fasting glucose,hypoalbuminemia,dysphagia,mechanical ventilation,indwelling gastric tube and deep vein intubation,but there was no statistical difference in different gender and hypertension patients. Conclusion SAP is caused by several risk factors,therefore the effective prevention and control measures should be adopted as far as possible to prevent the SAP according to the different risk factors.

关 键 词：卒中相关性肺炎 脑血管病 危险因素 

分 类 号：R563.1[医药卫生—呼吸系统]