痴呆患者发生院内获得性肺炎的危险因素分析  

Risk factors of nosocomial pneumonia in patients with dementia

作　　者：汪学翠 刘金华[1] 吕永良[1] 王卓樱 蔡黎杰 蔡宇 王浩 WANG Xuecui;LIU Jinhua;LYU Yongliang;WANG Zhuoying;CAI Lijie;CAI Yu;WANG Hao(Geriatric cognitive impairment area of Guangji Hospital of Suzhou,Jiangsu 215000,China)

机构地区：[1]苏州市广济医院老年认知障碍病区,215000

出　　处：《中国老年保健医学》2020年第5期90-93,共4页Chinese Journal of Geriatric Care

摘　　要：目的研究痴呆患者院内获得性肺炎相关风险因素,为临床预防院内感染及治疗提供依据。方法选择2017年3月至2020年5月我院收治的113例痴呆患者为研究对象,采用回顾性病例研究方法,统计分析纳入研究对象的临床资料,分析院内获得性肺炎的相关风险因素,为临床预防及治疗提供参考依据。结果113例痴呆患者发生肺院内获得性肺炎患者27例,感染率为23.89%,痴呆患者院内获得性肺炎风险与合并糖尿病、精神行为症状控制不稳定、吞咽困难、长期卧床、低蛋白血症、慢性支气管炎病史、住院时间超过3月、反复使用抗生素相关(P<0.05);多因素logistic回归分析提示合并糖尿病、精神行为症状控制不稳定、吞咽困难、慢性支气管炎病史、反复使用抗生素是痴呆患者院内获得性肺炎独立危险因素。结论痴呆患者发生院内获得性肺炎与精神行为症状控制不稳定、合并糖尿病、吞咽困难、慢性支气管炎病史、反复使用抗生素有关,在临床治疗过程中,应尽快控制精神行为症状,合理控制血糖,必要时鼻饲营养支持,加强重度痴呆患者生活护理,缩短住院时间,合理使用抗生素。Objective To study the risk factors associated with nosocomial pneumonia in patients with dementia and provide evidence for clinical prevention and treatment of nosocomial infections.Methods 113 dementia patients admitted to our hospital from March 2017 to May 2020 were selected as the research object.The retrospective case study method was used to statistically analyze the clinical data of the research subjects and analyze the relevant risk factors of acquired pneumonia in the hospital for prevention and treatment.Results In 113 patients with dementia,27 patients infected acquired nosocomial pneumonia,and the infection rate was 23.89%.The risk of acquired nosocomial pneumonia in patients with dementia was associated(P<0.05)with diabetes,unstable mental behavioral symptoms control,difficulty swallowing,long-term bed rest,and hypoproteinemia,chronic bronchitis history,hospitalization for more than three months,and repeated antibiotic usage;multivariate logistic regression analysis suggests combined diabetes,unstable mental behavioral symptoms control,dysphagia,history of chronic bronchitis.Repeated antibiotic usage is Independent risk factors for lung infection in patients with dementia.Conclusion The occurrence of nosocomial pneumonia in patients with dementia is related to unstable mental and behavioral symptoms,combined with diabetes,dysphagia,chronic bronchitis,and repeated usage of antibiotics.During clinical treatment,mental and behavioral symptoms should be controlled as soon as possible,and blood glucose should be reasonably controlled.When necessary,nasal feeding nutrition support,strengthen the life care of patients with severe dementia,shorten the length of hospital stay,and use antibiotics reasonably.

关 键 词：痴呆 院内肺炎危险因素 

分 类 号：R749.16[医药卫生—神经病学与精神病学] R563.1[医药卫生—临床医学]