老年急性脑卒中患者肺部感染危险因素与预防  

Risk factors and prevention strategies of the elderly acute cerebral apoplexy patients with pulmonary infections

作　　者：孙茂军[1] 陈琳迪[1] 寇雪莲[1] 唐维国[1] 於孝龙[1] 

机构地区：[1]浙江省舟山医院神经内科,浙江舟山316000

出　　处：《中华医院感染学杂志》2016年第7期1517-1519,共3页Chinese Journal of Nosocomiology

基　　金：舟山市科技局基金资助项目(2013C31062)

摘　　要：目的探讨老年急性脑卒中患者合并肺部感染发生的相关危险因素及预防策略,以有效控制降低其发生率,改善预后。方法选择医院2011年1月-2015年6月急性脑卒中患者864例,采用回顾性研究方法对其中69例感染患者的病原菌分布及感染相关因素进行统计分析;采用SPSS13.0软件进行统计分析。结果共分离出病原菌69株,其中革兰阳性菌26株占37.68%,革兰阴性菌39株占56.52%,真菌4株占5.80%;多因素logistic回归分析结果显示,年龄、高脂血症、糖尿病、高血压、慢性阻塞性肺疾病、脑卒中类型、侵入性操作、意识障碍、吞咽障碍、NIHSS评分、留置鼻饲时间、卧床时间和住院时间是老年急性脑卒中患者合并肺部感染发生的危险因素。结论老年急性脑卒中患者合并肺部感染的病原菌以革兰阴性菌为主,导致感染的危险因素众多,应针对危险因素,采取相应的预防措施,以控制和降低医院感染的发生。OBJECTIVE To retrospectively study risk factors of patients with elderly acute cerebral apoplexy and pulmonary infections,and analyze prevention strategies so that to effectively control and reduce incidence and improve prognosis.METHODS A total of 864 cases of acute stroke patients,including 69 cases with infections,were selected in the hospital from Jan.2011 to Jun.2015.With retrospective method,distribution of pathogenic bacteria and infection related factors of the 69 patients were statistically analyzed.RESULTS Pathogenic bacteria were respectively the gram-positive bacteria（26strains,37.68%）,the gram-negative bacteria（39strains,56.52%）,and the fungi（4strains,5.80%）.The results of multi-factor logistic regression analysis indicated that the risk factors of the elderly acute cerebral apoplexy patients with pulmonary infection were age,hyperlipidemia,diabetes,high blood pressure,COPD,stroke types,invasive operation,disturbance of consciousness,swallowing dysfunction,NIHSS score,lien nasal feeding time,and length of hospital stays.CONCLUSIONFor patients with elderly acute stroke with pulmonary infections,the major pathogenic bacteria are gram-negative bacteria.There are many risk factors associated with infections.It is suggested to target those risk factors and take corresponsive preventions so as to control and decrease incidence of infections.

关 键 词：急性脑卒中 肺部感染 老年患者 危险因素 预防策略 

分 类 号：R743.3[医药卫生—神经病学与精神病学]