脑出血后肺炎的临床及预后因素分析

Analysis of clinical and prognostic factors of elderly patients with pneumonia after intracerebral hemorrhage

目的探讨分析老年脑出血后肺炎的临床及预后相关因素。方法分析我院收治的47例老年脑出血合并肺炎患者的临床资料,同时选取47例单纯性的老年肺炎患者作为对照组。比较两组患者的临床资料、治疗效果以及脑出血组住院时间的影响因素,找出老年脑出血后肺炎的临床及预后相关因素。结果脑出血组与对照组住院时间、白细胞水平、中性粒细胞比例、白蛋白水平、高血压、糖尿病、痰细菌涂片阳性、痰培养阳性、机械通气与鼻胃管情况的差异比较有统计学意义(P<0.05);脑出血组治疗的有效率明显低于对照组(70.2%vs 89.4%χ2=5.343 P=0.021);脑出血组住院时间与低蛋白血症呈负相关(r=-0.572 P=0.003),与双侧肺炎、机械通气及鼻胃管呈正相关(r=0.347,0.551,0.692 P=0.017,0.002,0.024)。结论脑出血后并发肺炎的患者全身情况常较差,治疗效果不佳,患者的住院时间较长,其预后与低蛋白血症、双侧肺炎、机械通气及鼻胃管的使用密切相关。

Objective To explore the clinical and prognostic factors of elderly patients with pneumonia after intracerebral hemorrhage. Methods 47 elderly cerebral hemorrhage patients with pneumonia were selected as the observation group, and another 47 elderly pneumonia patients were selected as the control group. The clinical data, treatment effect and duration of hospital stay were compared in order to find out the clinical and prognosis related factors of senile patients with pneumonia after cerebral hemorrhage. Results There were certain differences in duration of hospital stay, white blood cells, neutrophils ratio, albumin level, hypertension, diabetes, sputum smear positive bacteria mechanical ventilation, positive sputum culture, mechanical ventilation and nasogastric tube between the two groups （P〈0.05）. The treatment efficiency of the observation group was lower than that of the control group （70.2% vs 89.4%, χ2=5.343, P=0.021）. The duration of hospital stay in the observation group was negatively correlated with hypoalbuminemia （r=0.572, P=0.572）, and was positively correlated with double pneumonia, mechanical ventilation and nasogastric tube （r=0.347, 0.551, 0.692, P=0.692, 0.002, 0.024 respectively）. Conclusion Patients with pneumonia after cerebral hemorrhage have poor systemic conditions and curative effect. Their prognosis is closely correlated with hypoalbuminemia, double pneumonia and use of mechanical ventilation and nasogastric tube.