急性脑卒中患者并发院内感染的临床特点及危险因素

Clinical characteristics and risk factors of nosocomial infections in patients with acute stroke

目的分析急性脑卒中患者并发院内感染的临床特点及危险因素。方法筛选2021年2月至11月于江苏省启东市人民医院治疗的180例急性脑卒中患者作为研究对象,分析患者治疗期间的院内感染发生率、临床特点及危险因素。结果180例患者治疗后的院内感染发生率为15.00%(27/180),其中下呼吸道感染高发。单因素分析显示,感染者的年龄、合并症、使用质子泵抑制剂、镇静类药物、格拉斯哥昏迷评分(GCS)评分、神经功能缺损程度(NIHSS)评分、日常生活能力(ADL)评分、抗生素预防应用、住院时间、肌力与非感染者比较,差异有统计学意义(P<0.05)。多因素分析显示,年龄≥60岁、合并症、使用镇静类药物及质子泵抑制剂、GCS评分<8分、NIHSS评分≥15分、ADL评分<50分、抗生素预防应用、住院时间>20 d、肌力≤3级为导致急性脑卒中患者并发院内感染的高危因素(P<0.05)。结论急性脑卒中患者院内感染发生率较高,在感染预防中需加强对药物、日常生活能力等可控因素的管理,达到改善患者预后效果的目的。

Objective To analyze the clinical characteristics and risk factors of nosocomial infection in patients with acute stroke.Methods From February to November 2021,180 patients with acute stroke who were admitted to Qidong People′s Hospital of Jiangsu Province for treatment were selected as the research objects,and the incidence,clinical characteristics and risk factors of nosocomial infection in the patients during treatment were analyzed.Results The incidence of nosocomial infection in 180 patients after treatment was 15.00%(27/180),among which the incidence of lower respiratory tract infection was high.Univariate analysis showed that there were significant differences in age of infected persons,complications,use of proton pump inhibitors,sedative drugs,Glasgow Coma Score(GCS),degree of neurological deficit of National Institute of Health Stroke Scale(NIHSS),ability of daily living(ADL)scores,preventive application of antibiotics,length of hospital stay and muscle strength between infected patients and non-infected patients(P<0.05).Multivariate analysis showed that age≥60 years old,with complication,use of sedative drugs and proton pump inhibitors,GCS score<8 points,NIHSS score≥15 points,ADL score<50 points,preventive application of antibiotics,length of hospital stay>20 days,muscle strength≤3 were the high-risk factors of nosocomial infection in patients with acute stroke(P<0.05).Conclusion The incidence of nosocomial infection in patients with acute cerebral stroke is high.In infection prevention,it is necessary to strengthen the management of controllable factors such as drugs and daily living ability to achieve the purpose of improving the prognosis of patients.