卒中相关性肺炎与缺血性脑卒中严重程度及预后的关系

Relationship of Stroke Associated Pneumonia with the Severity and Prognosis of Ischemic Stroke

目的探讨卒中相关性肺炎(SAP)与缺血性脑卒中严重程度及预后的关系。方法选取我院于2014年3月至2016年2月期间收治的69例缺血性脑卒中患者作为研究对象,根据患者是否被确诊为卒中相关性肺炎,分为SAP组与非SAP组。收集患者的一般资料,对两组患者的临床表现、相关检查结果、危险因素、住院时间以及病死率等进行分析,并对患者的病情及预后进行评估。结果 SAP组的年龄>75岁、意识障碍、吞咽困难、多发部位脑梗死的比例均显著高于非SAP组,差异有统计学意义(P<0.05)。SAP组的CRP、BNP、ALB以及ESR水平与非SAP组比较,差异有统计学意义(P<0.05)。SAP组的住院时间显著长于非SAP组,病死率显著高于非SAP组(均P<0.05)。SAP组的病情及预后评分均高于非SAP组,差异有统计学意义(P<0.05)。结论 SAP会使缺血性脑卒中患者的病情加重,住院时间延长,医疗费用增加,并且预后较差,具有较高的死亡率,临床中医护人员需要提高对SAP的认知,采取有效措施预防并发症的发生,从而缩短患者的住院时间,改善预后,提高生存率。

Objective To explore the relationship of stroke associated pneumonia（SAP） with the severity and prognosis of ischemic stroke. Methods 69 cases of patients with ischemic stroke admitted to our hospital from March 2014 to February 2016 were selected.According to patients＇ condition of disease,all cases were divided into SAP group and non-SAP group. The general information of patients were collected,patients＇ clinical manifestations,inspection results,risk factors,length of hospital stay,and mortality rate were analyzed,and patients＇ condition of disease and prognosis were evaluated. Results The proportions of aged over 75,disturbance of consciousness,dysphagia,multiple sites of cerebral infarction of SAP group were significantly higher than those of non-SAP group（P〈0.05）. The levels of CRP,BNP,ALB and ESR showed significant differences between two groups（P〈0.05）. The length of hospital stay of SAP group was significantly longer than that of non-SAP group,and the mortality rate was significantly higher than that of non-SAP group（P〈0.05）. The scores of disease condition and prognosis of SAP group were significantly higher than those of non-SAP group（P〈0.05）. Conclusions SAP can aggravate the condition of disease,prolong hospitalization time and increase medical expense of ischemic stroke patients; also,SAP can cause poor prognosis and higher mortality rate. Medical staff need to improve the knowledge of SAP,and take effective measures to prevent the occurrence of complications,so as to shorten patients＇ length of hospital stay,and improve patients＇ prognosis and survival rate.