老年脑卒中患者急性期呼吸道感染的临床分析

Clinical analysis of respiratory tract infections among elderly stroke patients at acute stage

目的探讨老年脑卒中患者急性期并发呼吸道感染的高危因素及治疗方法,以期提高临床对老年脑卒中急性期并发呼吸道感染的认识水平,提高该类患者的治疗质量。方法选取老年急性脑卒中患者1 983例,将并发呼吸道感染的97例患者随机分为对照组和观察组,分别为48、49例,对照组实施常规治疗,观察组实施支气管肺泡灌洗治疗,对两组患者治疗效果进行评价和比较。结果 1 983例患者共发生肺部感染97例,感染率为4.89%;患者年龄≥70岁、有脑卒中病史、慢性肺病史、意识障碍、吞咽障碍、合并糖尿病、合并低蛋白血症、合并肾功能不全、有侵入性操作、住院时间≥3周是老年脑卒中急性期并发呼吸道感染的相关危险因素(P<0.05);治疗后显效率和总有效率观察组分别为53.06%和87.76%,对照组分别为20.83%和56.25%,两组比较差异有统计学意义(P<0.05)。结论老年脑卒中急性期患者并发呼吸道感染与多种因素密切相关,临床工作中对这部分患者应给予适当的预防干预,通过支气管肺泡灌洗治疗可改善预后。

OBJECTIVE To investigate the high risk factors causing complicated respiratory tract infections to elderly stroke patients at acute stage and the relevant treatment methods so as to improve the clinically cognitive level of complicated respiratory tract infections of elderly stroke patients at acute stage and improve the treatment quality. METHODS A total of 1983cases of elderly stroke patients at acute stage were selected,and the 97patients who suffered from complicated respiratory tract infections were randomly divided into control group（48cases）and observation group（49cases）;patients of control group were given routine treatment and patients of observation group were given bronchoalveolar lavage（BAL）treatment;the therapeutic effects of the two groups were evaluated and compared.RESULTS Totally 97of the 1983patients suffered pulmonary infections,with an infection rate of 4.89%.Age of 70years old with history of stroke or chronic lung disease,disturbance of conscious,swallowing disorders,complicated diabetes,complicated hypoalbuminemia,complicated renal dysfunction,invasive procedures,and 3weeks or longer hospital stay were the relevant risk factors causing complicated respiratory infections to elderly stroke patients at acute stage（P＆lt;0.05）.After treatment,the significant efficiency and total effective rate of the observation group were 53.06%and 87.76%respectively,and that of the control group were 20.83% and 56.25%respectively;there were significant difference between the two group（P＆lt;0.05）.CONCLUSIONThe occurrence of respiratory infection in elderly stroke patients at acute stage is closely related to multiple factors,and it is required to provide appropriate preventative interventions for these patients in clinical practice and to improve the outcome through BAL treatment.