脑卒中伴吞咽障碍患者口腔感染的危险因素分析及预防措施  

Risk Factors and Preventive Measures for Oral Infections in Stroke Patients with Swallowing Disorders

作　　者：刘钰连 黄志强[1] 陈臻[1] Liu Yulian;Huang Zhiqiang;Chen Zhen(Department of Infection and Disease Prevention,Department of Neurology,Dazhou Integrated TCM and Western Medicine Hospital,Dazhou,Sichuan 635002,China)

机构地区：[1]达州市中西医结合医院医院感染与疾病预防科,神经内科,四川达州635002

出　　处：《四川医学》2024年第11期1193-1197,共5页Sichuan Medical Journal

基　　金：四川省中管局项目(编号:2023MS142)。

摘　　要：目的分析脑卒中伴吞咽障碍患者口腔感染的危险因素,并制定预防措施。方法选择2022年7月至2023年7月本院收治的164例脑卒中伴吞咽障碍患者,调查其口腔感染情况,并采用多因素Logistic回归分析脑卒中伴吞咽障碍患者口腔感染的独立危险因素。结果164例脑卒中伴吞咽障碍患者共42例口腔感染,口腔感染率25.61%。口腔感染组与无口腔感染组在年龄、是否合并糖尿病、有无经口胃管、是否使用抗生素方面比较差异有统计学意义(P<0.05),在性别、文化程度、卒中类型、病程、饮酒史、吸烟史、是否合并高血压、营养状态、生活能否自理、口腔护理频率方面比较差异无统计学意义(P>0.05)。多因素Logistic回归分析结果表明,年龄≥50岁(95%CI 1.168~1.636、1.767~7.504,P=0.000、0.000)、合并糖尿病(95%CI 1.822~4.989,P=0.000)、有经口胃管(95%CI 1.630~10.910,P=0.003)、使用抗生素(95%CI 1.225~4.051,P=0.009)是脑卒中伴吞咽障碍患者口腔感染的独立危险因素。结论本院收治的脑卒中伴吞咽障碍患者口腔感染风险高,结果提示与年龄≥50岁、合并糖尿病、有经口胃管、使用抗生素等多种因素有关,临床可基于独立危险因素制定针对性预防措施。Objective To analyze risk factors of oral infection in stroke patients with swallowing disorders and develop preventive measures.Methods From July 2022 to July 2023,164 stroke patients with swallowing disorders admitted to our hospital were collected to investigate the incidence of oral infections.Multivariate Logistic regression was applied to analyze the independent risk factors for oral infections in stroke patients with swallowing disorders.Results Total 42 out of 164 stroke patients with swallowing disorders developed oral infections,with an incidence rate of 25.61%.There were statistically significant differences between the oral infection group and the non-oral infection group in terms of age,whether complicated with diabetes,whether had an oral stomach tube,and whether used antibiotics(P<0.05),while there were no statistically obvious differences in terms of gender,education level,stroke type,course,drinking history,smoking history,whether complicated with hypertension,nutritional status,whether could take care of oneself in life,and oral care frequency(P>0.05).Multivariate Logistic regression analysis showed that age≥50 years old(95%CI=1.168~1.636,1.767~7.504,P=0.000,0.000),combined diabetes(95%CI=1.822~4.989,P=0.000),having an oral gastric tube(95%CI=1.630~10.910,P=0.003),and using antibiotics(95%CI=1.225~4.051,P=0.009)were independent risk factors for oral infection in stroke patients with dysphagia.Conclusion The risk of oral infection in stroke patients with dysphagia admitted to our hospital is high.The results suggest that it is related to multiple factors such as age≥50 years,diabetes,having oral gastric tube,using antibiotics and so on.Clinical prevention measures can be formulated based on independent risk factors.

关 键 词：脑卒中 吞咽障碍 口腔感染 危险因素 预防措施 

分 类 号：R743[医药卫生—神经病学与精神病学]