急性脑卒中患者肺部感染影响因素与临床干预措施分析

Analysis of risk factors and clinical intervention measures of acute stroke with pulmonary infections

目的分析急性脑卒中患者并发肺部感染的影响因素分析及临床干预措施。方法选取2014年1月-2017年1月于医院接受治疗的急性脑卒中患者236例为研究对象,其中并发肺部感染患者106例设为感染组,无并发肺部感染患者130例设为对照组;详细记录患者基本临床资料,包含住院时间、年龄、有无意识障碍、性别、是否有吸烟史、住院期间白蛋白和血糖含量、脑卒中类型、格拉斯哥昏迷评分(Glasgow Coma Scale,GCS)情况、急性期卧床时间、合并症情况、神经功能受损评分(National Institutes of Health Stroke Scale,NIHSS)情况、患者相关治疗和操作情况、吞咽评分,对患者发生感染和不同因素间的相关性进行分析。结果两组患者在年龄、吸烟、意识障碍、脑卒中类型、吞咽障碍、侵入性操作、H_2受体阻滞剂、使用抗菌药物、糖皮质的激素、NIHSS评分、住院时间、GCS评分、血糖的含量方面比较,差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,NIHSS评分、相关合并症、脑卒中类型和侵入性操作是肺部感染的影响因素(P<0.05)。结论急性脑卒中患者并发肺部感染的影响因素较多,在临床中医务工作者应针对患者发生感染的影响因素进行必要临床干预以预防感染发生。

OBJECTIVE To analyze the risk factors and clinical intervention measures of acute cerebral apoplexy complicated with pulmonary infections.METHODS A total of 236 cases of patients with acute stroke treated in our hospital from Jan.2014 to Jan.2017 were selected as the study objects,of which 106 cases complicated with pulmonary infections were set as infection group,and 130 cases without pulmonary infection were set as control group.The basic clinical data of the patients were recorded,including hospitalization time,age,consciousness disorder,genders,smoking history,albumin and blood glucose levels during hospitalization,types of stroke,Glasgow coma score（GCS）,acute period of time in bed,complications,nerve damaged scoring function（NIHSS）,patient related treatment and operation situations of patients,and dysphagia score,and the correlations between infection and different factors were analyzed.RESULTS There were significant differences between the two group in age,smoking history,consciousness disorder,stroke types,dysphagia,invasive operation,H2 receptor blocker,antibiotics use,glucocorticoid,NIHSS score,hospitalization time,GCS scores,and blood glucose levels（P〈0.05）.Multivariate logistic regression analysis showed that NIHSS scores,associated complications,stroke types and invasive operation were the influencing factors of pulmonary infection（P〈0.05）.CONCLUSIONThere are many risk factors for acute pulmonary infection in patients with acute stroke.Clinical practitioners in the clinic should conduct necessary clinical interventions to prevent infections according to risk factors of infections.