脑出血合并肺部感染的相关危险因素分析

Risk Factors of Cerebral Hemorrhage and Concurrent Pulmonary Infection

目的探讨与脑出血患者并发肺部感染相关的危险因素及其对预后的影响。方法对2012年12月至2013年11月宁夏医科大学总医院收治的304例脑出血患者相关临床资料进行回顾性分析。结果 1304例脑出血患者,并发肺部感染119例(39.14%)。脑出血合并肺部感染的发生与脑出血部位有关(P<0.05)。2单因素分析提示其相关危险因素有年龄、吸烟、意识障碍、吞咽困难、气管插管及气管切开、心脏病、慢性阻塞性肺病、糖尿病及低蛋白血症(P<0.05)。3多因素logistic回归分析结果显示合并吞咽困难、意识障碍、心脏病、糖尿病、吸烟及低蛋白血症为脑出血患者发生肺部感染的独立危险因素。4脑出血并发肺部感染组GCS评分低于无肺部感染组(P<0.05);死亡率和平均住院日高于无肺部感染组(P<0.05)。结论脑出血肺部感染发生与脑出血部位及多种因素相关,积极控制危险因素可降低其发生率及死亡率。

Objective To investigate the related risk factors and prognostic factors for pulmonary infections in patients with cerebral hemorrhage,so as to provide a reference to prevent and treat the complication of pulmonary infections in the future. Methods We retrospectively analyzed the clinical data of 304 patients with cerebral hemorrhage in the General Hospital of Ningxia Med. Univ. from December 2012 to November 2013. Results ①There were 119 patients who had pulmonary infections and infection rate was 39. 14%. It was found that there was a close relationship in pulmonary infections and cerebral hemorrhage site（ P〈0. 05）. ② The risk factors proned to pulmonary infections were aging,smoking,unconsciousness,difficulty in swallowing,tracheostomy and intubation,heart disease,chronic obstructive pulmonary disease,diabetes and hypoalbuminemia（ P〈0. 05）.③The independent risk factors for the pulmonary infections included the difficulty in swallowing,unconsciousness,heart disease,diabetes,smoking and hypoalbuminemia by logistic regression analysis. ④ Glasgow Coma Scale was lower,hospialization was prolonged and mortality was significantly higher when cerebral hemorrhage patients with pulmonary infections respect to patients without pulmonary infections（ P〈0. 05）. Conclusion There were a variety of the risk factors prone to pulmonary infections in patients with cerebral hemorrhage. Control of the risk factors in time can prevent pulmonary infection and reduce the mortality.