高血压性脑出血患者并发肺部感染的危险因素及护理对策分析

Risk factors and nursing countermeasures of pulmonary infection in patients with hypertensive cerebral hemorrhage

目的探讨高血压性脑出血患者并发肺部感染的危险因素及护理对策。方法选取2016年6月至2018年6月本院高血压性脑出血患者250例,分析患者并发肺部感染情况及其危险因素。结果本研究并发肺部感染的高血压性脑出血患者有100例、发生率为40%,分离病原菌150株,其中真菌10株(6.67%)、革兰阳性菌20株(13.33%)、革兰阴性菌120株(80.00%);单因素分析结果显示,年龄、吸烟、糖尿病、肺基础病、吞咽困难、格拉斯哥昏迷评分、出血量、气道侵入、鼻饲、镇静药物应用与高血压性脑出血并发肺部感染有关(P<0.05);logistic多因素分析结果显示,年龄≥60岁、吸烟、糖尿病、肺基础病、吞咽困难、格拉斯哥昏迷评分<8分、出血量≥100 mL、气道侵入、鼻饲、镇静药物应用是高血压性脑出血并发肺部感染的独立危险因素(P<0.05)。结论高血压性脑出血并发肺部感染的风险高,其病原菌以革兰阴性菌为主,其发生的危险因素多且复杂,应重视年龄≥60岁、糖尿病、肺基础病、吞咽困难、格拉斯哥昏迷评分<8分、出血量≥100 ml、气道侵入、鼻饲、镇静药物应用等人群的病情监测与护理干预。

Objective To discuss the risk factors and nursing countermeasures of pulmonary infection in patients with hypertensive cerebral hemorrhage.Methods Totally 250 patients with hypertensive cerebral hemorrhage were selected from June 2016 to June 2018 in our Hospital, and the concurrent pulmonary infection and its risk factors were analyzed.Results In this study,100 hypertensive cerebral hemorrhage patients were complicated with pulmonary infection,with the incidence 40. 00%,and 150 strains of pathogenic bacteria were isolated,including 10 strains of fungi( 6. 67%),20 strains of gram-positive bacteria( 13. 33%) and 120 strains of gram-negative bacteria( 80. 00%). Tunivariate analysis showed that,age,smoking,diabetes mellitus,pulmonary diseases,dysphagia,Glasgow coma score,bleeding volume,airway incision,nasal feeding and sedative drug use were related to hypertensive cerebral hemorrhage complicated with pulmonary infection( P < 0. 05). Logistic multivariate analysis showed that,60 years old and above,smoking,diabetes mellitus,pulmonary diseases,dysphagia,Glasgow coma score below 8,bleeding over 100 ml,airway incision,nasal feeding and sedative drug use were the independent risk factors for hypertensive cerebral hemorrhage complicated with pulmonary infection( P < 0. 05). Conclusion The risk of hypertensive cerebral hemorrhage complicated with pulmonary infection is high,the gram-negative bacteria are the main pathogens,and the risk factors are many and complex. We should pay attention to the condition monitoring and nursing intervention of patients with 60 years old and above,diabetes mellitus,pulmonary diseases,dysphagia,Glasgow coma score below 8,bleeding over 100 ml,airway incision,nasal feeding and sedative drug.