老年急性脑卒中患者肺部感染危险因素分析

Risk factors of pulmonary infections in elderly patients with acute brain stoke

目的对老年急性脑卒中合并肺部感染的危险因素进行分析,并对该类患者的预后进行探讨,为临床预防及治疗提供参考。方法收集160例发生急性脑卒中的老年患者临床资料,并根据其是否发生肺部感染分为感染组与非感染组,应用回归分析对发生肺部感染的因素进行多因素分析,并对其预后进行探讨。结果 160例老年急性脑卒中患者中,发生肺部感染24例,感染率为15.0%;感染组患者慢性阻塞性肺疾病病史、糖尿病史、吸烟史、意识障碍、长期卧床、吞咽困难、侵入性操作合并肺部感染率分别为62.5%、58.3%、62.5%、58.3%、58.3%、62.5、58.3%,明显高于非感染组患者36.8%、36.8%、36.0%、33.8%、33.8%、36.0%,差异有统计学意义(P<0.05);进一步行多因素分析显示,慢性阻塞性肺疾病病史、长期卧床、存在吞咽困难是老年急性脑卒中患者并发肺部感染的独立危险因素(P<0.05);两组患者NIHSS评分结果显示,未感染组患者NIHSS评分(3.2±0.7)分明显低于感染组患者(5.6±1.1)分,差异有统计学意义(P<0.05)。结论老年急性脑卒中患者合并肺部感染的发生与慢性阻塞性肺疾病病史、长期卧床、存在吞咽困难存在密切的相关性,是其发生的独立危险因素。

OBJECTIVE To analyze risk factors of pulmonary infections in elderly patients with acute brain stroke and discuss prognosis of the patients so as to guide the clinical prevention and treatment. METHODS The clinical data of 160 cases of elderly patients with acute brain stroke were collected, the patients were divided into the infection group and the non-infection group according to the status of pulmonary infections, then multivariate regression analysis was performed to analyze the causes of pulmonary infections, and the prognoses of the patients were evaluated. RESULTS Of totally 160 cases of elderly patients with acute brain stoke, the pulmonary infections occurred in 2,1 cases with the infection rate of 15.0~. The incidence rates of pulmonary infections of the infeczion group with COPD history , the history of diabetes, smoking history, disturbance of consciousness, long-term bedridden, dysphagia ,or invasive operation were respectively 62. 5%, 58. 3%, 62. 5%, 58. 3%, 58. 3%, 62.5%, and 58.3%0, significantly higher than 36.8%, 36.8%, 36.0%, 33.8%, 33. 8% and 36.0% of the control group, the difference was significant （P〈 0. 05）. The multivariate analysis indicated that the COPD history, long-term bedridden, and dysphagia were the independent risk factors of the＇pulmonary infections in the elderly patients with acute brain stoke（P〈0.05）. The NIHSS score revealed that the NIHSS score of the non- infection group was （3.2±0.7）, significantly lower than （5.6 ± 1. 1 ） of the infection group, the difference was significant（P〈0. 05）. CONCLUSION The incidence of pulmonary infections in the elderly patients with acute brain stroke is closely related to the COPD history, long-term bedridden, and dysphagia, which are the independent risk factors.