颈部脊髓损伤患者继发肺部感染的危险因素分析

Study on high risk factors of secondary pulmonary infection in patients with cervical spinal cord injury

目的探究颈部脊髓损伤(cervical spinal cord injury,CSCI)患者继发肺部感染的危险因素。方法回顾性分析本院康复医学科自2019年11月~2022年12月首次收治的CSCI患者190例,按是否继发肺部感染进行分组,分析CSCI患者继发肺部感染的危险因素。同时,对继发肺部感染的CSCI患者以是否合并低钠血症进行分组,探讨两组间是否存在差异性因素。结果190例CSCI患者中,62例继发肺部感染,128例无肺部感染。单因素分析显示,年龄、颈部脊髓损伤水平、ADL评分、ASA分级、血清Na+离子浓度、纤维蛋白原浓度的差异均具有统计学意义(P值均<0.05)。纳入多因素分析后,结果显示仅ASA分级(OR=0.59,95%CI:0.411-0.834,P<0.01)和纤维蛋白原水平(OR=3.20,95%CI:1.51-6.79,P<0.01)为CSCI患者继发肺部感染的独立危险因素。结论ASA分级和纤维蛋白原水平是CSCI患者继发肺部感染的独立危险因素。

Objective To explore the high-risk factors for secondary pulmonary infections in patients with cervical spinal cord injury(CSCI).Methods The retrospective analysis was conducted on 190 CSCI patients in our hospital for the first time from November 2019 to December 2022.These patients were divided into groups based on whether they had secondary pulmonary infections,and the high-risk factors for secondary pulmonary infections in CSCI patients were analyzed.Meanwhile,CSCI patients with secondary pulmonary infections were grouped based on whether they had hyponatremia,and the differences in factors between the two groups were explored.Results Among 190 CSCI patients,62 had secondary pulmonary infections and 128 had no pulmonary infections.The univariate analysis showed that age,cervical spinal cord injury level,ADL score,ASA grade,serum Na ion concentration,fibrinogen concentration,all had statistical significance(P values<0.05).In multivariate analysis,the results showed that only ASA grade(OR=0.59,95%CI:0.411-0.834,P<0.01)and fibrinogen level(OR=3.20,95%CI:1.51-6.79,P<0.01)were independent high-risk factors for secondary pulmonary infection in CSCI patients.Conclusion ASA grade and fibrinogen levels are independent high-risk factors for secondary pulmonary infection in CSCI patients.