脑出血患者并发肺部感染的相关危险因素及预防对策

Related risk factors and prevention countermeasures of patients with cerebral hemorrhage complicated with pulmonary infection

目的探讨脑出血患者并发肺部感染的相关危险因素及预防对策,为临床治疗提供依据。方法选择医院2012年1月-2015年6月住院治疗100例脑出血伴肺部感染患者(肺部感染组)、100例脑出血无肺部感染患者(未感染组)临床资料,分析引起肺部感染的危险因素。结果肺部感染组患者吸烟史、慢性阻塞性肺疾病史、糖尿病史、慢性支气管炎史、低蛋白血症、脑出血部位为脑室、使用呼吸机、鼻饲、吸痰、持续颅内高压、假性延髓性麻痹、预防性使用抗菌药物、使用糖皮质激素构成比分别为46.00%、10.00%、24.00%、14.00%、8.00%、44.00%、25.00%、28.00%、67.00%、32.00%、26.00%、46.00%、26.00%,高于未感染组34.00%、2.00%、12.00%、3.00%、1.00%、24.00%、11.00%、15.00%、53.00%、18.00%、13.00%、25.00%、11.00%,肺部感染组年龄、NIHSS评分(65.87±6.85)岁、(18.69±6.54)分高于未感染组(60.09±4.22)岁、(8.95±5.88)分,GCS评分(11.03±3.82)分低于未感染组(13.92±2.57)分,两组比较差异有统计学意义(P<0.05)。结论引起脑出血患者肺部感染的危险因素较多,针对相关因素应在治疗期间进行干预以降低肺部感染发生率。

OBJECTIVE To explore the related risk factors and prevention countermeasures of patients with cerebral hemorrhage complicated with pulmonary infection,so as to provide references for clinical treatment.METHODS Clinical data of 100 cases of patient with cerebral hemorrhage complicated with pulmonary infection（pulmonary infection group）and 100 cases of patient with cerebral hemorrhage without pulmonary infection（uninfected group）were randomly selected,and the risk factors of pulmonary infection were analyzed.RESULTS The constituent ratios of smoking history,history of chronic obstructive pulmonary disease,history of diabetes mellitus,history of chronic bronchitis,hypoalbuminemia,ventricular hemorrhage,use of breathing machine,nasal feeding,sputum suction,continuous intracranial pressure,pseudo bulbar palsy,prophylactic use of antibiotics,and use of corticosteroids of pulmonary infection group were 46.00%,10.00%,24.00%,14.00%,8.00%,44.00%,25.00%,28.00%,67.00%,32.00%,26.00%,46.00%,and 26.00%,respectively,which were high than those of uninfected group of 34.00%,2.00%,12.00%,3.00%,1.00%,24.00%,11.00%,15.00%,53.00%,18.00%,13.00%,25.00%,and 11.00%.The age and NIHSS score of pulmonary infection group were（65.87±6.85）years old and（18.69±6.54）points,which were higher than those of uninfected group of（60.09±4.22）years old and（8.95±5.88）points,the GCS score of pulmonary infection group was（11.03±3.82）points,which was lower than that of uninfected group of（13.92±2.57）points（P〈0.05）.CONCLUSIONThere are many risk factors for pulmonary infection in patients with cerebral hemorrhage,and interventions should be made according to related factors during the treatment to reduce the incidence of pulmonary infection.