长期住院的高龄脑卒中患者医院获得性肺炎危险因素分析

Risk factors of hospital acquired pneumonia in long-term hospitalized elderly stroke patients

【目的】分析影响长期住院的高龄脑卒中患者医院获得性肺炎(HAP)发病的危险因素,为制定相关干预措施提供依据。【方法】收集2015年7月—2017年6月上海市黄浦区老年护理医院和黄浦区顺昌医院老年护理病房出院病例,选取其中发生医院获得性肺炎的患者294例作为研究组,同时选取297例未发生医院获得性肺炎的患者作为对照组。采用病例对照研究方法,经单因素及多因素Logistic回归分析筛选影响高龄脑卒中患者HAP发病的危险因素。【结果】高龄脑卒中患者发病危险因素众多,本研究结果显示,合并3种及以上基础疾病、既往感染、留置胃管、空腹血糖、B型利钠肽、年龄、脑卒中部位是HAP重要危险因素。而性别、脑卒中分型、病史年限、血红蛋白、白蛋白未显示是危险因素。多因素Logistic回归分析显示,年龄、3种及以上基础疾病是高龄脑卒中患者HAP的独立危险因素。【结论】对于长期住院的高龄脑卒中患者,积极治疗合并基础疾病和并发症,是预防HAP的关键。

[Objective]To analyze the risk factors of hospital-acquired pneumonia(HAP)in elderly patients with long-term hospitalization and provides evidence for the development of relevant interventions.[Methods]A total of 294 patients with hospital-acquired pneumonia were selected as the study group and another 297 patients were HAP-free as control group.The patients were discharged from geriatric nursing hospitals and Shunchang hospital of Huangpu District from July 2015 to June 2017.A case-control study was performed to screen for risk factors for HAP in elderly patients with long-term hospitalization by univariate and multivariate Logistic regression analysis.[Results]There were many risk factors for stroke in elderly patients.The results of this study showed that combination with three or more underlying diseases,as previous infection,indwelling gastric tube,fasting blood glucose,BNP,age,stroke site proved to be an important risk factor for HAP.Stroke type,years of stroke history,hemoglobin and albumin were not shown to be risk factors.Multivariate Logistic regression analysis showed that age,3 or more underlying diseases were independent risk factors for HAP in elderly stroke patients.[Conclusion]For elderly patients with stroke,active treatment of underlying diseases and complications is the key to prevent HAP in elderly stroke patients.