某院ICU卒中老年患者医院获得性肺炎的病原学特点及危险因素分析  

Analysis of etiological characteristics and risk factors of hospital-acquired pneumonia in elderly stroke patients in ICU

作　　者：张英[1] 谢晓梅 许亚婷 章丹凤 刘红 ZHANG Ying;XIE Xiao-mei;XU Ya-ting;ZHANG Dan-feng;LIU Hong(Taizhou Hospital of Zhejiang Province,Taizhou Zhejiang 317000,China)

机构地区：[1]浙江省台州医院,浙江台州317000

出　　处：《中国消毒学杂志》2020年第11期826-828,共3页Chinese Journal of Disinfection

摘　　要：目的研究医院重症监护病房(ICU)收治的卒中老年患者医院获得性肺炎的病原学特点及危险因素。方法通过病原学检测和多因素分析方法,对某医院ICU住院的156例老年卒中患者的病历资料进行回顾性分析,以研究获得性肺炎病原菌特点及危险因素。结果共调查该医院ICU收治卒中老年患者156例,其中发生医院获得性肺炎38例,占24.36%。从患者送检标本中共分离出病原菌48株,其中革兰阴性菌、革兰阳性菌以及真菌的构成比依次分别为56.25%、37.50%和6.25%。多因素分析结果显示,患者的年龄、留置胃管、合并吞咽障碍、合并意识障碍、气管插管或切开、机械通气以及合并COPD病史等是卒中老年患者发生医院获得性肺炎的危险因素(P<0.05)。结论该医院ICU住院卒中老年患者医院获得性肺炎的发生率较高,相关致病菌以革兰阴性菌为主,应针对主要危险因素制定防控措施。Objective To study the etiological characteristics and risk factors of hospital-acquired pneumonia in elderly stroke patients admitted to the hospital ICU.Methods Through pathogenic testing and multivariate analysis,the medical records of 156 elderly stroke patients who were hospitalized in ICU of a hospital were analyzed retrospectively to study the pathogenic characteristics and risk factors of acquired pneumonia.Results A total of 156 elderly patients with stroke admitted to ICU of the hospital were investigated.Among them,38 cases of hospital-acquired pneumonia occurred,accounting for24.36%.A total of 48 strains of pathogenic bacteria were isolated from the specimens submitted by patients,among which the constituent ratios of Gram-negative bacteria,Gram-positive bacteria and fungi were 56.25%,37.50%and 6.25%respectively.The results of multivariate analysis showed that patient’s age,indwelling gastric tube,combination with dysphagia,combination with disturbance of consciousness,tracheal intubation or incision,mechanical ventilation and COPD history were the risk factors for hospital-acquired pneumonia in elderly stroke patients(P<0.05).Conclusion The incidence of hospital-acquired pneumonia in elderly stroke patients in ICU of this hospital is relatively high,and the related pathogenic bacteria are mainly Gram-negative bacteria.Prevention and control measures should be formulated for the main risk factors.

关 键 词：卒中 老年患者 医院获得性肺炎 病原菌 危险因素 

分 类 号：R181.23[医药卫生—流行病学]