住院患者发生吸入性肺炎的临床特点及相关因素探讨

Clinical characteristics and related factors of aspiration pneumonia in hospitalized patients

目的 分析探讨住院患者发生吸入性肺炎的临床特点及相关因素。方法 选择2014年1月—2018年12月于我院康复中心住院治疗的215例患者作为研究对象,收集入组患者的病历资料,分析吸入性肺炎发生的临床特点和危险因素。结果 入组215例患者中发生吸入性肺炎者45例(20.93%),45例中存在2种基础疾病者21例(46.67%)、3种者13例(28.89%)、4种者11例(24.44%);临床表现主要包括发热33例(73.33%)、有明显呛咳史25例(55.56%)、呼吸困难15例(33.33%)、意识障碍19例(42.22%)、咳嗽咳痰12例(26.67%)。Logistic回归分析显示,高龄、白蛋白水平低、合并基础疾病、咳嗽反射敏感性低、吞咽功能障碍、意识障碍、鼻饲或胃肠道营养、胃食管反流、气管插管、体位不当等均为住院患者发生吸入性肺炎的危险因素(P均<0.05)。结论 发生吸入性肺炎的住院患者以老年人群为主,且合并基础疾病多,临床症状不典型。高龄、营养状态差、生理反射障碍、意识障碍、胃食管反流、侵入性操作、体位不当等均为住院患者发生吸入性肺炎的危险因素。

Objective To analyze the clinical characteristics and related factors of aspiration pneumonia in hospitalized patients. Methods Two hundred and fifteen patients who were hospitalized in Rehabilitation Center of our hospital from January 2014 to December 2018 were selected as subjects. The medical records of 215 inpatients were collected and the clinical characteristics and risk factors of aspiration pneumonia in hospitalized patients were analyzed. Results Among the enrolled 215 patients, 45 cases (20.93%) developed aspiration pneumonia. Among the 45 affected cases, there were 21 cases (46.67%) with 2 kinds of underlying diseases, 13 cases (28.89%) of 3 kinds, and 11 cases (24.44%) of 4 kinds;The clinical manifestations included fever in 33 cases (73.33%), obvious cough history in 25 cases (55.56%), dyspnea in 15 cases (33.33%), consciousness disorder in 19 cases (42.22%), cough and expectoration in 12 cases (26.67%). Logistic regression analysis showed that advanced age, low albumin levels, combined underlying disease, low cough reflex sensitivity, swallowing dysfunction, disturbance of consciousness, nasal feeding or gastrointestinal nutrition, gastroesophageal reflux, endotracheal intubation, and improper position are risk factors for aspiration pneumonia in hospitalized patients (P <0.05). Conclusions Inpatients with aspiration pneumonia are mainly elderly, and there are many underlying diseases and atypical clinical symptoms. Advanced age, poor nutritional status, physiological reflex disorder, disturbance of consciousness, gastroesophageal reflux, invasive operation, and improper position are risk factors for aspiration pneumonia in hospitalized patients.