脑卒中患者肺部感染危险因素分析与预防  

Risk factors analysis and prevention for lung infection in patients with stroke

作　　者：袁祖琴[1] 沈朝阳[1] 张红金[1] 庞卫锋[1] 刘丹[1] 顾金涛[1] 徐红梅[1] 

机构地区：[1]常州市第七人民医院神经内科,江苏常州213011

出　　处：《中华医院感染学杂志》2016年第19期4434-4436,共3页Chinese Journal of Nosocomiology

基　　金：江苏省卫生厅医药卫生科研基金资助项目(H201123)

摘　　要：目的探讨脑卒中患者肺部感染的危险因素和预后,为脑卒中患者肺部感染的临床治疗提供理论依据。方法选取2010年6月-2015年7月于医院接受治疗253例脑卒中患者为研究对象,根据其是否发生肺部感染分为感染组61例和未感染组192例,统计分析感染组患者的病原菌分布及危险因素,观察比较两组患者治疗前后神经功能缺损评分及治疗效果。结果 253例脑卒中患者中发生肺部感染61例,感染率为24.11%;共检出病原菌71株,其中革兰阴性菌49株占69.01%,革兰阳性菌18株占25.35%,真菌4株占5.63%;脑梗死、吞咽障碍、高血糖、意识障碍、慢性肺疾病等患者肺部感染率明显较高,差异有统计学意义(P<0.05);治疗后,感染组患者神经功能损伤评分明显低于未感染组,差异有统计学意义(P<0.05);感染组患者病死率为24.59%,未感染组病死率为8.85%,两组之间差异有统计学意义(P<0.05)。结论脑卒中患者发生肺部感染的危险因素较多,在临床治疗中要注重预防。OBJECTIVE To discuss the risk factors and prognosis for lung infection in patients with stroke,so as to provide a theoretical basis for stroke patients with pulmonary infection clinical treatment.METHODS A total of 253 cases of stroke patients treated in the hospital from Jun.2010 to Jul.2015 were selected as the research objects,grouped into infection group 61 cases and uninfected group 192 cases according to pulmonary infection.The pathogens distribution and incidence of risk factors were analyzed in infection group,and the neurological deficit scores and treatment effect were observed and compared in two groups of patients before and after treatment.RESULTS There were 61 cases of lung infection happened in 253 patients with stroke,and the infection rate was 24.11%.A total of 71 strains of pathogens were detected,among which 49 strains were gram-negative bacteria,according to69.01%,18 strains of gram-positive bacteria,accounting for 25.35%,and 4strains of fungi,accounting for5.63%.Patients with cerebral infarction,dysphagia,hyperglycemia,disturbance of consciousness and chronic lung disease had significantly higher lung infection rate（P〈0.05）.After treatment,the neurological deficit scores in infection group were significantly higher than uninfected group（P〈0.05）;the mortality rate was 24.59%in the infection group,and the control group mortality rate was 8.85% and the differences were significant（P〈0.05）.CONCLUSION The risk factors for stroke patients with lung infection are more than others,which should be paid enough attention to prevention in clinical treatment.

关 键 词：脑卒中 肺部感染 危险因素 分析与预防 

分 类 号：R563.1[医药卫生—呼吸系统]