基底节区脑出血合并肺部感染的影响因素

Influencing factors for pulmonary infection in patients with basal ganglia hemorrhage

目的探究基底节区脑出血合并肺部感染患者的临床特点及影响因素,为临床防治提供参考依据。方法回顾性分析2017年5月-2018年5月医院收治的780例基底节区脑出血患者的临床病例资料,统计其肺部感染情况、病原菌分布,单因素及多因素Logistic回归分析肺部感染的影响因素。结果 780例基底节区脑出血患者共发生肺部感染50例,感染率为6.41%,共分离出39株病原菌,以革兰阴性菌为主,主要为肺炎克雷伯菌和鲍氏不动杆菌;多因素Logistic回归分析结果显示,糖尿病、肺部基础疾病、GCS评分3~8分、住院时间>14 d是患者发生肺部感染的影响因素。结论基底节脑出血患者感染以革兰阴性菌为主,感染因素较多,临床应针对高危因素制定相应的预防措施,降低肺部感染率。

OBJECTIVE To explore the clinical characteristics and influencing factors for pulmonary infection in the patients with basal ganglia hemorrhage so as to provide guidance for clinical prevention and treatment.METHODS The clinical data of 780 patients with basal ganglia hemorrhage who were treated in the hospital from May 2017 to May 2018 were retrospectively analyzed,the incidence of pulmonary infection and distribution of pathogens were statistically analyzed,and the univariate analysis and multivariate logistic regression analysis were performed for influencing factors for the pulmonary infection.RESULTS Of the 780 patients with basal ganglia hemorrhage,50 had pulmonary infection,with the infection rate 6.41%.A total of 39 strains of pathogens were isolated,among which the gram-negative bacteria were dominant;Klebsiella pneumoniae and Acinetobacter baumannii were the predominant species of the gram-negative bacteria.The result of multivariate logistic regression analysis showed that diabetes mellitus,pulmonary underlying disease,GCS ranging between 3 and 8 points and length of hospital stay more than 14 days were the influencing factors for the pulmonary infection.CONCLUSION The gram-negative bacteria are dominant among the pathogens isolated from the basal ganglia hemorrhage patients with infection,there are a variety of influencing factors for the infection,and it is necessary for the hospital to develop targeted prevention measures according to the high risk factors so as to reduce the incidence of pulmonary infection.