急性脑卒中患者肺部感染的预后及影响因素研究

Influencing factors for prognosis of acute cerebral stroke patients with pulmonary infection

目的探讨合并肺部感染的急性脑卒中患者的预后,并分析影响预后的因素。方法选取2014年8月-2016年5月132例急性脑卒中合并肺部感染患者为研究对象,根据预后情况分为预后良好组与预后不佳组,筛选出影响预后的相关因素,应用logistic回归分析进行多因素回归分析。结果 132例脑卒中合并肺部感染患者中有24例(18.2%)患者预后不佳,包括死亡7例(5.3%),108例(81.8%)预后良好;出院时预后良好组NIHSS评分明显低于预后不佳组,差异有统计学意义(P<0.05);预后良好组住院时间明显短于预后不佳组,差异有统计学意义(P<0.05);脑卒中类型、意识障碍、吞咽困难、糖尿病史、冠心病史、年龄及卧床时间与患者预后存在相关性,差异有统计学意义(P<0.05);logistics回归分析显示,出血性脑卒中、存在意识障碍、既往糖尿病史及高龄是影响患者预后的危险因素(P<0.05)。结论临床上对于出血性脑卒中、存在意识障碍、既往糖尿病史及高龄的急性脑卒中患者,需早期预防,不仅避免肺部感染的发生,且可提高急性脑卒中合并肺部感染的预后。

OBJECTIVE To explore the influencing factors for prognosis of acute cerebral stroke patients complicat- ed With pulmonary infection. METHODS A total of 132 acute cerebral stroke patients complicated with pulmonary infection who were treated in the hospital from Aug 2014 to May 2016 were recruited as the study objects and di- vided into the favorable prognosis group and the poor prognosis group according to the treatment outcomes. The influencing factors for the prognosis were screened out, and the multivariate logistic regression analysis was per- formed. RESULTS Of the 132 cerebral stroke patients complicated with pulmonary infection, 24 （18.2%） had poor prognosis, including 7 （5.3%） cases of death, and 108 （81.8%） had favorable prognosis. The NIHSS score of the favorable prognosis group was significantly lower than that of the poor prognosis group （P〈0.05）. The length of hospital stay of the favorable prognosis group was significantly shorter than that of the poor prognosis group（P〈 0.05）. The prognosis of the patients was associated with the types of cerebral stroke, disturbance of conscious- ness, dysphagia, history of diabetic mellitus, history of coronary heart disease, age, and bedridden time（P〈 0.05）. The logistics regression analysis showed that the risk factors for the prognosis of the patients incltlded the hemorrhagic stroke, disturbance of consciousness, history of diabetic mellitus, and advanced age （P〈 0, 05）. CONCLUSION It is necessary for the hospital to take prevention measures in early stage for the patients with hem- orrhagic stroke, disturbance of consciousness, history of diabetic mellitus, and advanced age so as to prevent the pulmonary infection and improve the prognosis of the acute cerebral stroke patients wit pulmonary infection.