老年脑卒中偏瘫合并肺部感染的临床特点及危险因素分析

Clinical characteristics and risk factors of senile stroke with hemiplegia complicated with pulmonary infection

目的探讨老年脑卒中偏瘫合并肺部感染的临床特点、危险因素分析。方法收集2014年1月至2018年1月临床确诊的104例老年脑卒中偏瘫患者的病历资料。根据是否发生肺部感染分为感染组(n=52)和非感染组(n=52),应用logistic回归分析对发生肺部感染的因素进行多因素分析。结果 104例老年脑卒中偏瘫合并肺部感染患者中,感染组慢性阻塞性肺疾病(COPD)病史、糖尿病史、吸烟史、意识障碍、长期卧床、吞咽困难、侵入性操作合并肺部感染率分别明显高于非感染组[(5.71±0.66)分比(3.19±0.47)分,(34.63±4.72)d比(25.73±3.82)d,P均<0.05];经logistic回归多因素分析显示COPD病史、长期卧床、吞咽困难及意识障碍是老年脑卒中偏瘫合并肺部感染的独立危险因素(P<0.05);感染组的美国国立卫生研究院卒中量表(NIHSS)评分及住院时间均高于非感染组,同时感染组病死率(28.85%)高于非感染组(9.62%),P<0.05。结论老年脑卒中偏瘫患者合并肺部感染的发生与COPD病史、长期卧床、吞咽困难及意识障碍密切相关,是其独立危险因素。

Objective To investigate the clinical characteristics and risk factors of hemiplegic and pulmonary infection in elderly patients with stroke.Methods A total of 104 elderly patients with stroke hemiplegia from January 2014 to January 2018 were collected.The patients were divided into infection group(n=52) and non-infection group(n=52) according to whether they had pulmonary infection or not.Logistic regression analysis was used to conduct multi-factor analysis on the factors of pulmonary infection and corresponding prevention strategies were proposed.Results Among 104 cases,pulmonary infection in chronic obstructive pulmonary disease(COPD) infection group medical history,history of diabetes,smoking history,disturbance of consciousness,long-term lie in bed,difficulty swallowing,invasive operation by pulmonary infection rates in patients with pulmonary infection were significantly higher than the non-infection group(P<0.05).Logistic regression showed that COPD history,long-term bed rest,dysphagia and disturbance of consciousness were independent risk factors for stroke hemiplegia combined with pulmonary infection in the elderly(P<0.05).NIHSS score and hospital stay in the infected group were higher than those in the non-infected group,and the fatality rate of the infected group(28.85%) was higher than that of the non-infected group(9.62%),P<0.05.Conclusion The incidence of pulmonary infection in senile stroke hemiplegia patients is closely related to the history of COPD,long-term bed rest,dysphagia and disturbance of consciousness,which is an independent risk factor for the occurrence of this disease.