进展性出血脑卒中患者肺部感染危险因素分析

Risk factors for pulmonary infections in patients with progressive hemorrhagic cerebral stroke

目的探讨和分析进展性出血脑卒中患者肺部感染危险因素,为临床诊治工作提供参考依据。方法选取2010年1月-2012年12月住院治疗的出血性脑卒中患者120例作为研究对象,根据合并肺部感染的情况将其分为感染组(83例)和非感染组(37例),对两组患者的临床资料、入院治疗、病情严重程度、血肿扩大等数据应用SPSS13.0统计软件进行统计分析,进展性出血卒中并发肺部感染的危险因素分析采用logistic多元回归进行分析。结果感染组中年龄>60岁、吸烟、意识障碍、吞咽障碍、并发疾病发生、接受侵入性操作治疗、应用糖皮质激素、血肿扩大和严重卒中患者分布率均显著高于非感染组,差异有统计学意义(P<0.05);logistic多元回归分析结果显示,存在基础疾病(χ2=5.534,OR=5.293)、有侵入性操作(χ2=4.761,OR=12.346)、卒中严重程度(χ2=5.024,OR=1.467)、有血肿扩大(χ2=8.921,OR=1.646)均与出血性进展性脑卒中合并肺部感染具有相关性,差异有统计学意义(P<0.05)。结论存在合并疾病、侵入性操作治疗、脑卒中严重程度、血肿扩大均是出血性进展性脑卒中患者合并肺部感染的相关危险因素,临床医护人员应综合考虑上述因素,做好感染的预防、治疗和护理工作。

OBJECTIVI To explore the risk factors for pulmonary infections in the patients with progressive hemorrhagic cerebrai stroke so as to provide guidance for the clinical diagnosis and treatment. METHODS Totally 120 cases of progressive hemorrhagic stroke, who were hospitalized for treatment from Jan 2010 to Dec 2012, were enrolled in the study and divided into the infection group with 83 cases and the non-infection group according to the status of pulmonary infections, then the clinical data, hospitalized treatment, severity of disease, and enlargement of hematoma of the patients in the two groups were statistically analyzed with the use of SPSS13.0 software, and the multivariate logistic regression analysis was performed for the risk factors for pulmonary infections in the patients with hemorrhagic progressive stroke. RESULTS The proportions of the patients with more than 60 years of age, smoking history, disorders of consciousness, dysphagia, concurrent disease, invasive procedures, use of corticosteroids, hematoma enlargement, or severe stroke were significantly higher in the infection group than in the non-infection group, the differences were statistically significant（P0.05）. The result of the multivariate logistic regression analysis revealed that concurrent underlying disease （;g= 5. 534, OR = 5. 293）, invasive procedures （）/2----4. 761, OR= 12. 346）, severity of stroke, and hematoma enlargement （Z2 = 8. 921,OR= 1. 646） were the factors associated with the pulmonary infections in the patients with progressive hemorrhagic cerebral Stroke, the differences were statistically significant （P % 0. 05）. CONCLUSION The concurrent diseases, invasive procedures, severity of stroke, and hematoma enlargement are the risk factors associated with the pulmonary infections in the patients with hemorrhagic progressive stroke; it is necessary for the medical staff to comprehensively consider the risk factors and take effective prevention and nursing measures.