慢性脑出血后肺炎病原菌分布及其预后影响因素调查研究

Investigation on pathogenic bacteria distribution and prognostic factors of chronic pneumonia after intracerebral hemorrhage

目的探究慢性脑出血后肺炎患者病原菌分布及其预后影响因素，旨在为采取针对性的预防干预措施减少慢性脑出血后肺炎发生提供参考依据。方法选取浙江省温岭市第四人民医院内科2011年6月～2013年6月收治的80例慢性脑出血后肺炎患者为研究对象，采用自编问卷收集上述患者的临床资料，应用SPSS19．0统计学软件包分析慢性脑出血后肺炎患者病原菌分布及预后影响因素。结果慢性脑出血后肺炎预后良好率为87．50％，病原菌以革兰阴性杆菌感染为主，占70．59％，多因素Logistic回归分析发现机械通气、吞咽反射障碍和病原菌类别是慢性脑出血后肺炎患者预后的危险因素．胸腹式呼吸训练是慢性脑出血后肺炎患者预后的保护因素。结论慢性脑出血后肺炎预后尚可，病原菌以革兰阴性杆菌感染为主。预后因素有机械通气、吞咽反射障碍、病原菌类别和胸腹式呼吸训练。我们在对慢性脑出血后肺炎患者进行治疗时，应该加强胸腹式呼吸训练指导。改善患者的预后。

Objective To analyze the pathogenic bacteria distribution and prognostic factors of chronic pneumonia after intraeerebral hemorrhage. Methods Eighty chronic pneumonia after intraeerebral hemorrhage patients who were treated in the internal medicine of the fourth hospital in wenling city of Zhejiang province from June 2011 to June 2013 were chosen as the research objects. The clinical data of all the subjects were collected. The clinical data were analyzed by the SPSS19.0 statistical package to find out the pathogenic bacteria distribution and prognostic factors of chronic pneu- monia after intracerebral hemorrhage. Results Good prognosis rate of the chronic pneumonia after intracerebral hemor- rhage patients was 87.50%,the gram-negative bacterium was the main pathogenic bacteria,accounted for 70.59%.Mul- tiariable logistic regression analysis showed that mechanical ventilation,swallowing reflex obstacles and pathogen cate- gory were risk prognostic factors of elderly chronic pneumonia after intraeerebral hemorrhage,chest breathing training was a protection prognostic factor of the chronic pneumonia after intracerebral hemorrhage. Conclusion The prognosis of the chronic pneumonia after intracerebral hemorrhage patients is tolerableness,the gram-negative bacterium is the main pathogenic bacteria.The prognostic factors of chronic pneumonia after intracerebral hemorrhage is concerned with mechanical ventilation,swallowing reflex obstacles,pathogen category and chest breathing training.We treat the chronic pneumonia after cerebral hemorrhage,we should strengthen the chest breathing training guidance and improve the prognosis of patients.