老年脑卒中患者医院下呼吸道感染的临床与病原学分析

Nosocomial Pulmonary Infection and Its Pathogens in Elderly Cerebral Apoplectic Patients

目的 探讨老年脑卒中患者医院下呼吸道感染的临床及病原学特点。方法 >6 0岁的老年脑卒中患者6 0 1例 ,合并医院下呼吸道感染患者 83例 ,对其临床及病原学特点进行回顾性分析。结果 老年脑卒中医院下呼吸道感染的病死率比不合并院内下呼吸道感染的老年脑卒中组明显增加 ,金黄色葡萄球菌是最重要的致病菌 ,其次是肺炎克雷伯菌 ,医院下呼吸道感染与病情严重程度、住院时间、意识状态、吞咽障碍、吸引术、使用肾上腺皮质激素、预防性应用抗菌药、合并糖尿病、出血破入脑室系统有密切联系。结论 老年脑卒中患者医院下呼吸道感染是由于多种因素相互作用的结果 ,预防和治疗医院下呼吸道感染需采取综合措施。

OBJECTIVE To investigate the clinical features and the pathogens of nosocomial pulmonary infection in elderly cerebral apoplectic patients. METHODS An epidemiological survey on the prevalence, fatality, sputum culture results and other aspects of nosocomial pulmonary infection was conducted in 601 elderly patients with apoplexy. RESULTS Patients with nosocomial pulmonary infection in elderly apoplexy were refered to poor outcome and high fatality. The most common pathogens were Staphylococcus aureus and Klebsiella pneumoniae. The incidence rate of nosocomial infection was related positively to primary disease severity, long time in hospital, consciousness, swallow, preventive antibiotic therapy and in patients with diabetes and breaking into ventricle of cerebral hemorrhage (P<0.01). CONCLUSIONS The results show that the nosocomial pulmonary infection in elderly cerebral apoplectic patients is caused by correlation of many risk factors. Comprehensive measures are necessary to the prevension and respiratory monitoring may be helpful in early diagnosis and treatment of the nosocomial pulmonary infection in elderly cerebral apoplectic patients.