急性脑梗死并发肺部感染的临床分析  

Clinical analysis of acute cerebral infarction complicated with pulmonary infection

作　　者：徐萍[1] 吴明华[2] 曹盼盼[1] 刘爱娟[1] 姚蓓蓓[1] XU Ping WU Minghua CAO Panpan LIU A ijuan YAO Beibei(Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province, Nanjing 210029, China En- cephalopathy Center, Jiangsu Provincial Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Jiangsu Province, Nanjing 210029, China)

机构地区：[1]南京中医药大学附属医院,江苏南京210029 [2]南京中医药大学附属江苏省中医院脑病中心,江苏南京210029

出　　处：《中国医药导报》2017年第13期50-53,共4页China Medical Herald

基　　金：江苏省第五期"333高层次人才培养工程"专项(BRA 2016507)

摘　　要：目的研究急性脑梗死后并发肺部感染的危险因素、预后以及防治措施,为临床预防与控制提供参考。方法采用病例对照研究方法,收集2015年1月~2016年1月南京中医药大学附属江苏省中医院脑病中心病房496例急性脑梗死患者的临床资料,分析可能影响患者并发肺部感染的危险因素,并分析肺部感染对患者预后的影响。结果本研究中急性脑梗死并发肺部感染率为13.9%。单因素分析结果示,感染组与非感染组比较,年龄、住院时间、吸烟史、意识障碍、球麻痹、梗死部位、侵入性操作、慢性肺病、心脏病病史、高血脂、脑卒中史、癫痫、癌症、低蛋白血症差异有统计学意义(P<0.05)。Logistic回归分析发现,年龄、住院时间、吸烟史、意识障碍、球麻痹、大面积梗死、慢性肺病、癌症是并发肺部感染的独立危险因素(P<0.05)。结论急性脑梗死并发肺部感染将导致临床症状加重、住院时间延长、病死率增加,应提高对并发肺部感染危险因素的认知与重视程度,加强危险因素控制,早期合理有效运用抗生素,发挥中医药在耐药细菌性肺部感染的优势,改善患者预后。Objective To study the risk factors, prognosis and prevention measures of acute cerebral infarction （AC1） complicated with pulmonary infection, in order to provid related reference for clinical prevention and control. Methods The case-control research method was used. The medical data of total 496 ACI patients were selected into the research in Encephalopathy Center, Jiangsu Provincial Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from January 2015 to January 2016. The risk factors of acute cerebral infarction complicated with pulmonary infection were analzyed. The influence of pulmonary infection on the prognosis was also analyzed. Results The incidence of pulmonary infection in ACI patients was 13.9%. Single factor analysis had showed that there were statistically differences in age, hospital stay, smoking history, consciousness disorder, bulbar paralysis, infarct location, invasive operation, chronic lung disease, heart disease h/story, hyperlipidemia, stroke history, epilepsy, cancer, and hy- poproteinemia between the infection group and the non-infection group （P 〈 0.05）. Moreover, Logistic regression analy- sis revealed that there were independent risk factors of pulmonary infection such as the advanced age, hospital stay, smoking history, consciousness disorder, bulbar paralysis, massive infarction, chronic lung disease and cancer （P 〈 0.05）. Conclusion The occurrence of complicated pulmonary infection will aggravate the clinical symptoms, lengthen the hospital stay, and increase the mortality. The prevention measures should be taken as the improvement of awareness and focus on the risk factors of complicated pulmonary infection, strengthening control of risk factors, and reasonable and effective use of antibiotics in the early stage. Meanwhile, the prognosis improvement is benefited by making use of the advantages of traditional Chinese medicine in the treatment of drug-resistant bacterial lung infection.

关 键 词：急性脑梗死 肺部感染 危险因素 预后 防治措施 

分 类 号：R743.33[医药卫生—神经病学与精神病学]