急性脑卒中并发肺部感染的危险因素分析

Risk factor for acute cerebral stroke complicated with pulmonary infection

目的对急性脑卒中并发肺部感染的危险因素进行分析,探讨其临床干预措施。方法 210例急性脑卒中并发肺部感染患者(感染组),210例急性脑卒中未并发肺部感染患者(对照组),比较2组年龄、性别、合并症、脑卒中性质、意识障碍、生活习惯、格拉斯哥昏迷评分(Glasgow Coma Scale,GCS)和美国国立卫生院神经功能缺损评分(National Institutes of Health Stroke Scale,NIHSS)等,分析并发肺部感染的危险因素。结果感染组高龄、有吸烟史、意识障碍、脑出血、吞咽困难患者比例,住院时间,血糖、白蛋白水平及NIHSS评分高于对照组(P<0.05),GCS评分低于对照组(P<0.05);感染组肾功能不全、呼吸系统疾病、糖尿病、心脏病及免疫系统疾病比例及有侵入性操作、使用糖皮质激素、预防性使用抗生素、使用H2受体阻滞剂比例均高于对照组(P<0.05)。Logistic回归分析结果显示,脑卒中类型、合并症、侵入性操作及高NIHSS评分是急性脑卒中患者发生肺部感染的独立危险因素。结论急性脑卒中并发肺部感染与脑卒中类型、合并症、侵入性操作及高NIHSS评分相关。

Objective To analyze the risk factors for acute cerebral stroke complicated with pulmonary infection and to explore the clinical intervention measures. Methods A total of 210 cases of acute cerebral stroke complicated with pulmonary infection （infection group） and another 210 cases of acute cerebral stroke not complicated with pulmonary infection （control group） were compared the age, gender, complications, stroke characters, disturbance of consciousness, living habits, GCS score and NIHSS score to analyze the risk factors for pulmonary infection. Results The aged, smoking history, disturbance of consciousness, cerebral hemorrhage, swallowing dysfunction, hospitalization duration, plasma glucose and albumin levels, and NIHSS score were higher in infection group than those in control group, and GCS score was lower in infection group than that in control group （P〈0.05）. The incidences of renal insufficiency, pulmonary disease, diabetes mellitus, heart disease and immune system disease, and the application rates of invasive procedures, glucoeorticoid, preventive antibiotics and H2 receptor blocking agents were higher in infection group than those in control group （P〈0.05）. Logistic regression analysis showed cerebral stroke type, combined diseases, invasive procedure and high NIHSS score were independent risk {actors for pulmonary infection in patients with acute cerebral stroke. Conclusion Acute cerebral stroke complicated with pulmonary infection is involved in cerebral stroke type, combined diseases, invasive procedures and high NIHSS score.