ICU脑梗死患者合并肺部感染的独立危险因素分析

Analysis of independent risk factors of pulmonary infection in patients with cerebral infarction in ICU

目的 探讨ICU脑梗死合并肺部感染的独立危险因素,为制订ICU脑梗死预防和治疗方案提供参考依据。方法 选取2018年4月—2021年3月在杭州市第一人民医院ICU治疗的165例脑梗死患者,根据是否合并肺部感染分为合并肺部感染组和未合并肺部感染组。采用二元logistic回归分析脑梗死患者合并肺部感染的独立危险因素,运用线性回归分析实验室指标与合并肺部感染的关系。结果 二元logistic回归分析结果显示,年龄≥60岁、侵入性操作、饮酒史、大面积梗死、意识障碍是导致脑梗死患者合并肺部感染的独立危险因素(P<0.05)。线性回归分析结果显示,动脉血氧分压(PaO_(2))、酸碱度(pH)对脑梗死患者合并肺部感染产生正向影响,肿瘤坏死因子(TNF-α)、二氧化碳分压(PaCO_(2))对脑梗死患者合并肺部感染产生负向影响。结论 脑梗死患者合并肺部感染不仅受梗死位置、意识状态、侵入性操作、年龄等因素的影响,还与PaO_(2)、pH、TNF-α、PaCO_(2)密切相关。针对这些因素,应积极采取科学措施加强院内感染控制。

Objective To explore the independent risk factors of cerebral infarction complicated with pulmonary infection, so as to provide reference for formulating the prevention and treatment plan of cerebral infarction.Methods 165 patients with cerebral infarction admitted to the ICU of Hangzhou First People’s Hospital from April, 2018 to March,2021 were selected. They were divided into the group with pulmonary infection and the group without pulmonary infection according to whether they were complicated with pulmonary infection. Binary logistic regression was used to analyze the independent risk factors of pulmonary infection in patients with cerebral infarction, and linear regression was used to analyze the relationship between laboratory indexes and pulmonary infection.Results The results of binary logistic regression analysis showed that age ≥ 60 years old,invasive operation,drinking history,large-area infarction and consciousness disorder were the independent risk factors of pulmonary infection in patients with cerebral infarction(P<0.05). Linear regression analysis showed that PaO_(2) and pH had a positive effect on pulmonary infection in patients with cerebral infarction, TNF-α and PaCOhas a negative effect on pulmonary infection in patients with cerebral infarction.Conclusion Pulmonary infection in patients with cerebral infarction is not only affected by infarct location,state of consciousness,invasive operation,age and other factors,but also related with PaO_(2),pH,TNF-α and PaCO_(2).In view of these factors,scientific measures should be taken to actively strengthen the control of nosocomial infection.