老年脑梗死患者肺部感染的危险因素及对预后的影响

Risk factors for pulmonary infections in elderly patients with cerebral infarction and its influence on the prognosis

目的探讨老年脑梗死患者发生肺部感染的危险因素及肺部感染对老年脑梗死患者预后的影响。方法回顾性分析临沂市沂水中心医院2013年10月至2014年5月符合条件的老年脑梗死患者968例的临床资料，统计肺部感染发生率并探讨其危险因素及对患者预后的影响。结果本组患者肺部感染发生率为10．32％，其中上呼吸道感染占18．O％，下呼吸道感染占82．0％；医院感染的发生率与患者年龄、性别无关（P〉0．05），与患者意识障碍、住院时间及侵入性操作有关（P〈0．05）；发生肺部感染的患者死亡率增加，NIHISS评分下降程度差异有统计学意义（P〈0．01）；发生肺部感染患者住院时间延长，住院费用增加。结论老年脑梗死患者肺部感染发生率高，意识障碍、住院时间及侵入性操作是老年脑梗死患者肺部感染的主要危险因素，肺部感染严重影响患者预后。

Objective To investigate the risk factors of pulmonary infection in elderly patients with cerebral infarction, pulmonary infection and the impact on the prognosis of patients with cerebral infarction in elderly. Methods A retro- spective analysis of the clinical data in the hospital from October 2013 to May 2014 in line with the conditions of elderly patients with cerebral infarction was conducted, and explore the incidence of pulmonary infection statistics and the risk factors and the impact on patient prognosis. Results The pulmonary infection rate was 10. 32%, of which the upper respiratory tract infection rate was 18.0%, the lower respiratory tract infection rate was 82. 0%. The incidence of pulmonary infection was irrelated with the patients age and sex（ P 〉0. 05 ）, but was related with disturbance of consciousness, length of hospital stay and invasive operation（ P 〈 0. 05 ）. Mortality in patients with pulmonary infection increased, NIHISS scores declined, and the differences were significant （P 〈0. 01 ）. Duration of hospitalization prolonged in patients with pulmonary infection, hospital costs increased. Conclusions The incidence of pulmonary infections in elderly patients with cerebral infarction is high ; disturbance of consciousness, length of hospital stay and invasive operation are major risk factors for pulmonary infections in elderly patients with cerebral infarction, has serious effect on the prognosis of patients with pulmonary infection.