脑卒中住院康复患者卒中相关性肺炎危险因素分析

Risk factors of stroke-associated pneumonia in stroke inpatients at rehabilitation stage

目的探讨脑卒中住院康复患者发生卒中相关性肺炎的危险因素。方法采用回顾性调查方法,收集2017年1月—2018年12月271例脑卒中首次住院康复患者一般临床资料,按有无肺炎分组,观察并分析两组一般临床资料,包括性别、年龄、住院时间、病程、Brunnstrom分期(上肢-手-下肢)、Barthel指数、洼田饮水试验分级、有无留置胃管、有无认知障碍、有无失语症、既往高血压病史、既往糖尿病病史、吸烟饮酒史、白蛋白及血红蛋白指标,从单因素分析中筛选出有统计学意义的观察指标,再进行多因素logistic回归分析。结果两组间年龄、住院时间、Barthel指数、Brunnstrom上肢/手/下肢分期、洼田饮水试验分级、留置胃管、白蛋白含量、血红蛋白含量、认知障碍、失语症差异有统计学意义(P<0.05);多因素logistic回归分析显示,留置胃管[比值比=52.463,95%置信区间(4.154,662.658),P=0.002]是发生肺炎的独立危险因素。结论留置胃管是发生肺炎的独立危险因素,针对危险因素,采取积极有效预防措施,有助预防肺炎发生。

Objective To explore the risk factors of stroke-associated pneumonia in stroke inpatients at rehabilitation stage.Methods A retrospective survey was conducted to collect the general clinical data of 271 patients with stroke who were hospitalized for the first time between January 2017 and December 2018.They were divided into two groups according to the presence or absence of pneumonia.The general clinical data of the two groups were observed and analyzed,including sex,age,length of stay,course of disease,Brunnstrom Stage,Barthel Index,scores of Kubota’s Water Drinking Test,indwelling gastric tube,cognitive impairment,aphasia,hypertension history,diabetes history,history of smoking and drinking,albumin content,and hemoglobin content.Statistically significant factors were screened out from single factor analysis,and then multivariate logistic regression analysis was conducted.Results There were significant differences in age,length of stay,Barthel Index,Brunnstrom Stage(upper limb,hand and lower limb),scores of Kubota’s Water Drinking Test,indwelling gastric tube,albumin content,hemoglobin content,cognitive impairment,and aphasia between the two groups(P<0.05).Multivariate logistic regression analysis showed that indwelling gastric tube [odds ratio=52.463,95% confidence interval(4.154,662.658),P=0.002] was an independent risk factor for pneumonia.Conclusions Indwelling gastric tube is an independent risk factor for pneumonia.In view of the risk factor,taking active and effective preventive measures can help prevent pneumonia.