2型糖尿病患者医院获得性肺炎影响因素及预防对策研究

Influencing factors for hospital-acquired pneumonia in patients with type 2 diabetes mellitus and prevention countermeasures

目的研究2型糖尿病患者发生医院获得性肺炎的影响因素,并据此提出相应预防对策。方法选取医院2014年6月—2016年6月收治1362例2型糖尿病患者为研究对象,其中将发生医院获得性肺炎患者120例作为研究组;另按照1:1配对选取同期入院治疗且未感染的120例2型糖尿病患者作为对照组;回顾性分析患者的临床资料,分析2型糖尿病患者发生医院获得性肺炎的影响因素。结果 1362例糖尿病患者中,发生医院获得性肺炎为120例,发生率为8.8%;单因素分析结果显示,年龄、病程、入院季度、入院时并存感染、住院时间、促胃动力药等为2型糖尿病患者发生医院获得性肺炎的影响因素;多因素Logistic回归分析发现,血清白蛋白下降≤40.0 g/L、餐后2 h血糖>11.0 mmol/L、服用促胃动力药、入院季度(第二、三季度)、病程>10年、年龄≥60岁、住院时间>10 d为2型糖尿病患者发生医院获得性肺炎独立影响因素。结论 2型糖尿病患者发生医院获得性肺炎影响因素较多,因此临床需根据患者发病高危因素实施针对性措施,降低2型糖尿病患者医院获得性肺炎发病率,为促进患者康复提供保障。

OBJECTIVE To explore the influencing factors for hospital-acquired pneumonia in patients with type 2 diabetes mellitus so as to put forward the prevention countermeasures.METHODS A total of 1362 patients with type 2 diabetes mellitus who were treated in hospitals from Jun 2014 to Jun 2016 were recruited as the study objects, 120 of whom had hospital-acquired pneumonias and were assigned as the study group.In a 1 ：1 ratio, totally120 type 2 diabetes mellitus patients without infection were set as the control group.The clinical data of the patients were retrospectively analyzed, and the influencing factors for the hospital-acquired pneumonia in the type 2 diabetes mellitus patients were observed. RESULTS Of the 1362 diabetes mellitus patients, 120 had hospital-acquired pneumonias, with the incidence rate 8.8%.The influencing factors for the hospital-acquired pneumonia in the type 2 diabetes mellitus patients included age, course of disease, quarter of admission, concurrent infection at admission, length of hospital stay and prokinetic drugs.The multivariate logistic regression analysis showed that decrease of serum albumin level by no more than 40.0 g/L, 2 h postprandial blood glucose level more than 11.0 mmol/L,administration of prokinetic drugs,admission in the second and third quarter, course of disease more than 10 years, no less than 60 years of age and length of hospital stay more than 10 days were the independent influencing factors for the hospital-acquired pneumonia in the type 2 diabetes mellitus patients.CONCLUSION There are a variety of influencing factors for the hospital-acquired pneumonia in the type 2 diabetes mellitus patients.It is necessary for the hospital to take targeted measures according to the high risk factors so as to reduce the incidence rate of hospital-acquired pneumonia in the type 2 diabetes mellitus patients and facilitate the rehabilitation of the patients.