脑卒中后吞咽功能障碍患者继发吸入性肺炎的独立危险因素分析

Analysis on independent risk factors for secondary aspiration pneumonia in patients with swallowing dysfunction after stroke

目的分析脑卒中后吞咽功能障碍患者继发吸入性肺炎的独立危险因素。方法回顾性分析2015年9月~2018年8月我院收治的60例脑卒中后吞咽功能障碍未继发吸入性肺炎患者(非肺炎组)与60例脑卒中后吞咽功能障碍继发吸入性肺炎患者(肺炎组)的临床资料,采用Logistic回归分析脑卒中后吞咽功能障碍继发吸入性肺炎的危险因素。结果两组在年龄>70岁、咳嗽无力、基础疾病、体位不当、鼻饲时间>2个月等资料比较差异有统计学意义(P均<0.05),而性别、反复吸痰、吸烟史、低蛋白血症等资料比较差异无统计学意义(P均>0.05);Logistic回归分析显示:年龄>70岁、基础疾病、体位不当、鼻饲时间>2个月是脑卒中后吞咽功能障碍继发吸入性肺炎的独立危险因素(P均<0.05)。结论本研究中导致脑卒中后吞咽功能障碍患者继发吸入性肺炎的独立危险因素包括年龄>70岁、基础疾病、体位不当、鼻饲时间>2个月,临床上针对此类患者应关注上述指标,并予以对应预防措施,以减少吸入性肺炎发生。

Objective To analyze the independent risk factors for secondary aspiration pneumonia in patients with swallowing dysfunction after stroke. Methods The clinical data of 60 patients with swallowing dysfunction after stroke who had no secondary aspiration pneumonia (non-pneumonia group) and 60 patients with swallowing dysfunction after stroke who had secondary aspiration pneumonia (pneumonia group) in our hospital from September 2015 to August 2018 were retrospectively analyzed. The Logistic regression analysis was used to analyze the risk factors for secondary aspiration pneumonia in patients with swallowing dysfunction after stroke. Results There were statistically significant differences between the two groups in the data of age over 70 years old, cough and weakness, underlying disease, improper position and nasal feeding for over 2 months (all P < 0.05). There were no statistically significant differences in data of gender, repeated sputum suction, smoking history and low proteinemia (all P > 0.05). Logistic regression analysis showed that age over 70 years old, underlying disease, improper position and nasal feeding for over 2 months were independent risk factors for secondary aspiration pneumonia in patients with swallowing dysfunction after stroke (all P < 0.05). Conclusion The independent risk factors for secondary aspiration pneumonia in patients with swallowing dysfunction after stroke include age over 70 years old, underlying disease, improper position and nasal feeding for over 2 months. Clinically, these patients should be paid attention to the above indexes and given corresponding preventive measures to reduce the occurrence of aspiration pneumonia.