综合气道管理对卒中相关性肺炎患者平均住院时间及预后的影响

Effects of integrated respiratory tracts management on average hospital stay and prognosis in patients with stroke-associated pneumonia

目的探讨综合呼吸道管理对卒中相关性肺炎患者平均住院时间及预后的影响。方法采集自2010年4月至2011年6月发生卒中相关性肺炎患者90例,其中采用综合呼吸道管理45例为干预组,因患方原因而呼吸道管理不完善45例为对照组,分别统计住院时间、预后、抗生素使用时间等指标。结果干预组平均住院时间10.32 d,其中家属签字出院2例,肺炎治愈好转出院43例;对照组平均住院时间11.52 d,其中家属签字出院16例,肺炎治愈病情好转出院29例,两组住院时间比较,差异无统计学意义(P=0.085)。两组好转率比较,差异有统计学意义(P=0.007)。干预组平均使用抗生素9.50 d,对照组使用11.01 d,两组比较,差异有统计学意义(P=0.042);神经功能美国国立卫生研究院卒中量表(NIHSS)评分比较出院、入院评分差值,干预组为4.3分,对照组为2.1分,两组比较,差异有统计学意义(P=0.021)。结论进行综合呼吸道管理可以改善卒中相关性肺炎患者预后,减少抗生素使用,有利于卒中康复。

Objective To explore the effects of integrated respiratory tracts management on average length of stay（ALOS） and prognosis of stroke-associated pneumonia（SAP）. Methods 90 patients with SAP were collected since 2010 and divided in- to two groups. 45 patients with integrated respiratory tracts management were regarded as the intervention group and other 45 pa- tients with imperfect respiratory tracts management due to the patients＇ reasons were as the control group. The indexes such as A- LOS, prognosis, use time of antibiotics were statistically analyzed. Results ALOS in the intervention group was 10.32 d,includ- ing 2 cases of discharge from hospital after family signature and 43 cases of discharge form hospital after pneumonia was cured or improved ; while ALOS in the control group was 11.52 d, including 16 cases of discharge from hospital after family signature and 29 cases of discharge from hospital after pneumonia was cured or improved. The comparison of ALOS between the two groups had no statistically significant difference （P=0.085） ;the average use time of antibiotics was 9.5 d in the intervention group and 11.01 d in the control group with statistically significant difference between them （P=0.042） ;in the comparison of the neurological function scores in the National Institutes of Health Stroke Scale （NIHSS） ,the difference of admission to hospital and discharge from hospi tal was 4.3 in the intervention group and 2.1 in the control group, the difference between them showed statistical significance （P= 0.021 ）. Conclusion Conducting the integrated respiratory tracts management can improve the prognosis of SAP,reduce the ap- plication of antibiotics and benefit to stroke recovery.