颈部脊髓损伤急性期肺部感染危险因素

Risk factors for pulmonary infection in acute stage of cervical spinal cord injury

目的探讨颈部脊髓损伤(CSCI)急性期肺部感染的危险因素。方法回顾性分析108例CSCI患者(C1~C8脊髓损伤)的临床资料,根据发病后1个月内是否发生肺部感染,分为肺部感染组和非肺部感染组。分析两组患者的基本情况、受伤形式、相关实验室检查等相关资料。结果108例患者中,55例发生肺部感染,肺部感染发生率为50.9%。单因素分析发现,低血红蛋白水平、ASIA分级、低钠血症、呼吸机辅助通气可能是CSCI患者发生肺部感染的影响因素(均P<0.05)。多因素logistic回归分析结果显示,ASIA分级(OR=0.399,95%CI:0.227~0.702,P=0.001)、呼吸机辅助通气(OR=77.564,95%CI:8.587~700.595,P<0.001)、血清钠离子水平(OR=0.839,95%CI:0.735~0.958,P=0.009)为CSCI患者肺部感染的危险因素。结论对于CSCI患者,ASIA分级A或B级、使用呼吸机辅助通气,以及低钠血症是肺部感染的独立危险因素。

Objective To explore the risk factors for pulmonary infection(PI)in acute stage of cervical spinal cord injury(CSCI).Methods Clinical data of 108 patients with CSCI(C1-C8 spinal cord injury)were analyzed retrospectively,according to whether PI occurred within 1 month after disease onset,patients were divided into PI group and non-PI group.Basic condition,injury type and relevant laboratory examination of two groups of patients were analyzed.Results Of 108 patients,55 had PI,incidence of PI was 50.9%.Univariate analysis showed that low hemoglobin level,ASIA grade,hyponatremia and ventilator-assisted ventilation may be the influencing factors for PI in patients with CSCI(all P<0.05).Multivariate logistic regression analysis showed that ASIA grade(OR=0.399,95%CI:0.227-0.702,P=0.001),ventilator-assisted ventilation(OR=77.564,95%CI:8.587-700.595,P<0.001),and serum sodium ion level(OR=0.839,95%CI:0.735-0.958,P=0.009)were risk factors for PI in patients with CSCI.Conclusion ASIA grade A or B,ventilator-assisted ventilation and hyponatremia are independent risk factors for PI in patients with CSCI.