老年脑卒中患者并发卒中相关性肺炎的影响因素分析  

Influencing factors of stroke-associated pneumonia in elderly patients with stroke

作　　者：薄磊 陶钰[2] 陈晶[3] BO Lei;TAO Yu;CHEN Jing(Department of Neurology,Nanjing 210006,China;ICU in Department of Respiratory and Critical Care Medicine,Nanjing 210006,China;Department of Medical Oncology,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)神经内科,南京210006 [2]南京医科大学附属南京医院(南京市第一医院)呼吸与危重症医学科监护室,南京210006 [3]南京医科大学附属南京医院(南京市第一医院)肿瘤内科,南京210006

出　　处：《公共卫生与预防医学》2025年第2期143-147,共5页Journal of Public Health and Preventive Medicine

摘　　要：目的初步分析老年脑卒中患者并发卒中相关性肺炎(stroke-associated pneumonia,SAP)的影响因素,总结SAP预防干预策略。方法选取2022年1月至2024年9月在南京市第一医院就诊的284例老年脑卒中患者纳入研究。纳入患者按照是否并发SAP分为SAP组(n=87)与非SAP组(n=197)。查阅两组患者的病历资料,进行单因素分析与多因素分析。结果研究纳入患者合并SAP 87例,SAP并发率30.63%。经χ^(2)检验非SAP组与SAP组是否留置胃管、是否留置尿管、是否合并糖尿病、卒中严重程度、吞咽障碍程度、意识障碍程度、是否长期卧床、白细胞计数、中性粒细胞计数、淋巴细胞计数、血同型半胱氨酸比较,差异有统计学意义(P<0.05)。logistic回归分析显示,留置胃管(OR=2.040;95%CI:1.138~3.659)、重度脑卒中(OR=2.121;95%CI:1.287~3.497)、中度吞咽障碍(OR=4.797;95%CI:1.512~15.217)、重度吞咽障碍(OR=9.816;95%CI:2.708~35.578)、重度意识障碍(OR=7.637;95%CI:1.833~31.813)、长期卧床(OR=2.347;95%CI:1.179~4.669)、白细胞计数异常(OR=1.988;95%CI:1.135~3.482)是脑卒中老年患者并发SAP的影响因素(P<0.05)。结论留置胃管、重度脑卒中、严重吞咽障碍、重度意识障碍、长期卧床、白细胞计数异常是老年脑卒中患者并发SAP的影响因素,临床诊治发现高危患者应及时采取预防措施。Objective To preliminarily analyze influencing factors of stroke-associated pneumonia(SAP)in elderly patients with stroke,and to summarize prevention and intervention strategies of SAP.Methods A total of 284 elderly patients with stroke who visited Nanjing Hospital affiliated to Nanjing Medical University from January 2022 to September 2024 were enrolled for the study.According to presence or absence of SAP,the patients were divided into SAP group(n=87)and non-SAP group(n=197).The case data in the two groups were collected.Statistical analysis of data was conducted using univariate analysis and multivariate analysis.Results A total of 87 patients with SAP were included in this study,with an SAP complication rate of 30.63%.The 2 test showed that there were significant differences between the two groups in gastric tube indwelling,catheter indwelling,diabetes mellitus,severity of stroke,severity of dysphagia,severity of consciousness disorder,long-term bed rest,white blood cell count,neutrophil count,lymphocyte count,and serum homocysteine level(P<0.05).Logistic regression analysis showed that indwelling gastric tube(OR=2.040;95%CI:1.138-3.659),severe stroke(OR=2.121;95%CI:1.287-3.497),moderate dysphagia(OR=4.797;95%CI:1.512-15.217),severe dysphagia(OR=9.816;95%CI:2.708-35.578),severe disturbance of consciousness(OR=7.637;95%CI:1.833-31.813),long-term bed rest(OR=2.347;95%CI:1.179-4.669),and abnormal white blood cell count(OR=1.988;95%CI:1.135-3.482)were influencing factors of SAP in elderly patients with stroke(P<0.05).Conclusion Gastric tube indwelling,severe stroke,severe dysphagia,severe disturbance of consciousness,long-term bed rest and abnormal white blood cell count are influencing factors of SAP in elderly patients with stroke.In clinical diagnosis and treatment,preventive measures should be taken in time for high-risk patients with stroke complicated by SAP.

关 键 词：老年患者 脑卒中 卒中相关性肺炎 

分 类 号：R181[医药卫生—流行病学]