急性脑卒中并发院内获得性肺炎192例临床分析

Clinical analysis of 192 cases of nosocomial pneumonia induced by acute stroke

目的探讨急性脑卒巾患者并发院内获得性肺炎的致病菌构成及防治措施。方法回顾性分析我院192例急性脑卒中并发院内获得性肺炎患者的临床资料。结果192例患者呼吸道分泌物培养出13种、116株致病菌，大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌和金黄色葡萄球菌居前4位，其中革兰阴性菌对亚胺培南敏感，革兰阳性菌则对万古霉素敏感。结论急性脑卒中并发院内获得性肺炎的主要致病菌为大肠埃希菌和铜绿假单胞菌。对患者加强医疗护理措施．加强医院感染的管理，提高急性脑卒巾并发肺炎的预见性，积极控制肺炎有利于降低其死亡率。

Objective To investigate the bacteriological distribution of nosocomial pneumonia induced by acute stroke, and to improve the preventative and therapeutic measures. Methods The clinical data of 192 patients with nosocomial pneumonia induced by acute stroke were analyzed respectively. Results Among the 192 cases, 13 pathogenic microorganisms and 116 strains were cultivated, and the first 4 strains were Escherichia coli, Pseudomonas aeruginosa, Klebsiella and Staphylococcus aureus. Gram-negative bacteria were sensitive to imipenem, and Gram-positive bacteria were sensitive to vancomycin. Conclusion The main pathogens of nosocomial pneumonia in acute stroke patients may be Escherichia coli and Pseudomonas aeruginosa. The measures improving the therapeutic outcome of acute stroke include the enhancement of nursing quality, prevention of cross infection in hospital, increasing predictability of the occurrence of pneumonia induced by acute stroke, and the control of pneumonia.