脑卒中患者意识状况对医院感染发生及预后的影响分析  

Influence of consciousness state in stroke patients on nosocomial infection and prognosis

作　　者：汤小姣[1] 王小春[1] 乐忠宏[1] 崔婷婷[1] 王姣[1] TANG Xiao-jiao WANG Xiao-chun LE Zhong-hong CUI Ting-ting WANG Jiao(Jiaozuo City Peoplets Hospital, Jiaozuo, Henan 454000, Chin)

机构地区：[1]焦作市人民医院干部病房老年科,河南焦作454000

出　　处：《中华医院感染学杂志》2017年第4期812-814,818,共4页Chinese Journal of Nosocomiology

基　　金：河南省指导性计划项目(201504028)

摘　　要：目的研究脑卒中患者意识状况对医院感染发生及预后的影响分析。方法选取2015年10月-2016年1月医院收治的脑卒中患者85例,按照脑卒中患者意识状态分为昏迷组33例和清醒组52例,根据患者脑卒中类型,给予相对应的治疗,并对符合医院感染的患者及时给予敏感性较高的抗菌药物治疗。结果昏迷组33例患者中有22例发生医院感染,感染率为66.67%,清醒组52例患者中有10例发生医院感染,感染率为19.23%,两组患者医院感染率比较,差异有统计学意义(P<0.01);昏迷组感染患者中病原菌分布率高于清醒组患者,差异有统计学意义(P<0.05);治疗前,两组受感染患者CSS评分差距较小,治疗后,两组受感染患者CSS评分均能得到降低,差异有统计学意义(P<0.05),且清醒感染组患者降低的幅度优于昏迷感染组,差异有统计学意义(P<0.05);清醒组感染患者的治疗有效率为90.00%,明显高于昏迷感染组45.45%,差异有统计学意义(P<0.05);经过治疗后,昏迷组感染患者住院时间均达(31.20±5.60)d,住院费用也相应提高为(2.30±0.80)万元,较清醒组感染患者明显提高,差异有统计学意义(P<0.05)。结论昏迷的脑卒中患者更易发生医院感染,经有效治疗后,预后较差,是临床急需解决的一大医疗问题。OBJECTIVE To analyze the influence of consciousness of stroke patients on nosocomial infections and prognosis.METHODS A total of 85 cases of stroke patients treated from Oct.2015 to Jan.2016 were selected,and were divided into coma group（33cases）and awake group（52cases）according to the consciousness state of stroke patients.According to the stroke type,the patients were given the corresponding treatment,and the patients with nosocomial infection should be treated with high sensitive antimicrobials in time.RESULTS In coma group,22 cases occurred nosocomial infection,accounting for 66.67%,and in awake group,10 cases occurred nosocomial infection,with the infection rate of 19.23%,and the difference was statistically significant（P〈0.01）.The distribution of pathogenic bacteria in coma group was significantly higher than that in awake group,and the difference was statistically significant（P〈0.05）.Before treatment,the CSS score gap between the two groups of infected patients was smaller,and after treatment,the CSS scores of both groups were reduced,and the difference was statistically significant（P0.05）.The CSS score of awake group reduced more than that of coma group,and the difference was significant（P〈0.05）.The effective rate of awake group was 90.00%,which was significantly higher than that of coma infection group（45.45%）,and the difference was statistically significant（P0.05）.After treatment,the length of hospital stay was（31.2±5.6）days and the cost of hospitalization was（23.0±8.0）thousand yuan in coma group,which were significantly higher than those in awake group,and the difference was significant（P〈0.05）.CONCLUSIONStroke patients with coma are more susceptible to nosocomial infection,and the prognosis is poor after effective treatment,which is a major medical problem to be solved urgently.

关 键 词：脑卒中 意识状况 医院感染 预后 

分 类 号：R181.32[医药卫生—流行病学]