脑卒中后长期卧床患者肺部感染预测模型构建及护理对策  

Construction of a predictive model and nursing countermeasures of pulmonary infection in long-term bedridden patients after stroke

作　　者：李兴慧 王莉[2] LI Xinghui;WANG Li(Geriatrics Department,Zaozhuang Mental Health Center,Zaozhuang 277100;Emergency Department,Zaozhuang Municipal Hospital,Zaozhuang 277100,China)

机构地区：[1]枣庄市精神卫生中心老年病科,山东枣庄277100 [2]枣庄市立医院急诊科,山东枣庄277100

出　　处：《临床医学研究与实践》2025年第9期46-49,共4页Clinical Research and Practice

摘　　要：目的探究脑卒中后长期卧床患者肺部感染的危险因素,构建预测模型分析其预测价值,并制定相应的护理对策,为临床防治提供依据。方法选取2023年1月至10月枣庄市精神卫生中心老年病科收治的84例脑卒中后长期卧床患者为研究对象,根据住院期间是否发生肺部感染将其分为感染组及非感染组,收集两组患者的一般资料。采用单因素及多因素Logistic回归分析探讨脑卒中后长期卧床患者肺部感染危险因素并构建预测模型;采用受试者工作特征(ROC)曲线分析其预测价值,并制定护理对策。结果84例脑卒中后长期卧床患者中,有32例发生肺部感染,发生率为38.10%。感染组与未感染组的糖尿病史、吞咽困难、侵入性操作、低蛋白血症占比比较,差异具有统计学意义(P<0.05)。多因素Logistic回归分析显示,糖尿病史、侵入性操作是脑卒中后长期卧床患者发生肺部感染的独立危险因素(P<0.05)。根据多因素Logistic回归分析构建风险预测模型,经ROC曲线分析显示,Logit(P)>0.456时,曲线下面积(AUC)为0.799,95%CI为0.696~0.902,约登指数为0.464,灵敏度为65.6%,特异度为80.8%。结论脑卒中后长期卧床患者肺部感染的发病率较高。糖尿病史、侵入性操作是脑卒中后长期卧床患者发生肺部感染的独立危险因素,据此构建的预测模型对肺部感染具有良好的预测价值,临床工作中可依据此模型对脑卒中后长期卧床患者肺部感染进行预测,并针对患者高危因素进行针对性的护理,以降低肺部感染的发生率及死亡率。Objective To explore the risk factors of pulmonary infection in long-term bedridden patients after stroke,to construct a predictive model to analyze its predictive value,and to formulate corresponding nursing countermeasures to provide a basis for clinical prevention and treatment.Methods A total of 84 long-term bedridden patients after stroke admitted in the geriatrics department of Zaozhuang Mental Health Center from January to October 2023 were selected as the research objects.According to whether pulmonary infection occurred during hospitalization,the patients were divided into infection group and non-infection group.The general data of patients of the two groups were collected.Univariate and multivariate Logistic regression analysis were used to explore the risk factors of pulmonary infection in long-term bedridden patients after stroke were analyzed and the prediction model was constructed;the receiver operating characteristic(ROC)curve was used to analyze its predictive value,and nursing countermeasures were formulated.Results Among the 84 long-term bedridden patients after stroke,32 cases had pulmonary infection,with an incidence of 38.10%.There were significant differences in the proportions of diabetes history,dysphagia,invasive operation and hypoproteinemia between the infected group and the non-infection group(P<0.05).Multivariate Logistic regression analysis showed that diabetes history and invasive operation were independent risk factors for pulmonary infection in long-term bedridden patients after stroke(P<0.05).According to multivariate Logistic regression analysis,a risk prediction model was constructed.ROC curve analysis showed that when Logit(P)>0.456,the area under the curve(AUC)was 0.799,95%CI was 0.696-0.902,Youden index was 0.464,sensitivity was 65.6%,and specificity was 80.8%.Conclusion The incidence of pulmonary infection in long-term bedridden patients after stroke is still high.The diabetes history and invasive operation are independent risk factors for pulmonary infection in long-term

关 键 词：脑卒中 肺部感染 长期卧床 

分 类 号：R743[医药卫生—神经病学与精神病学]