脑卒中患者肺部感染的危险因素分析与防控措施

Study on risk factors of pulmonary infection in patients with cerebral apoplexy and its control measures

目的研究脑卒中患者肺部感染的危险因素并探讨防控措施。方法通过回顾性调查与资料分析方法,对本院2011年1月至2016年1月期间210例脑卒中住院患者资料进行回顾性分析,调查肺部感染及其影响因素。结果 210例脑卒中住院患者中发生肺部感染患者32例,感染率为15.23%;从感染患者送检标本中分离出56株病原菌,其中革兰阴性杆菌34株,占60.71%,革兰阳性菌18株,占32.14%,真菌4株,占7.14%;年龄、有意识障碍、有吞咽困难、卒中类型、合并心脏病、糖尿病、有侵入性操作、预防性使用抗菌药物、使用抑酸药物等因素与患者肺部感染有密切关系。结论肺部感染在老年脑卒中住院患者中发生率较高,病原菌分布复杂且影响因素多,应当采取针对危险因素相关的防控措施。

Objective To study the risk factors of pulmonary infection in patients with cerebral apoplexy,and to explore the preventive measures. Methods Retrospective survey and data analysis method were used to investigate and analyze the pulmonary infection and influence factors of patients with cerebral apoplexy in our hospital during January 2011 and January 2016.Results There were 210 cases of cerebral apoplexy patients in the hospital,and 32 cases had pulmonary infection and the infection rate was 15. 23%. 56 strains of pathogenic bacteria were isolated from the specimens collected from infected patients,which including 34（ 60.71%） strains of Gram negative bacilli,18（ 32.14%） strains of Gram positive bacilli,4（ 7.14%） strains of fungi. The factors of age,disturbance of consciousness,cardiopathy,dysphagia,stroke types,diabetes,invasive operation,prophylactic use of antimicrobial and use of acid suppressive drugs were closely related to the pulmonary infection.Conclusions The incidence of pulmonary infection in elderly hospitalized patients with cerebral apoplexy is high,pathogen distribution is complex and with lots of risk factors,related prevention and control measures should be taken in view of the risk factors.