摘要
目的探讨神经内科ICU老年脑卒中患者医院获得性肺炎发生的特点。方法采取前瞻性研究的方法,对215例医院获得性肺炎的临床资料进行统计分析。结果脑卒中患者医院获得性肺炎感染发生率为36.3%。logistic回归分析显示,年龄>70岁、意识障碍、吞咽困难、吸烟和住院时间是医院获得性肺炎的危险因素。医院获得性肺炎患者的病原茵主要为革兰阴性杆菌,占59.8%,其中以鲍曼不动杆菌(31.5%)、肺炎克雷伯茵(13.0%)、铜绿假单胞菌(5.4%)、大肠埃希菌(4.3%)为主。医院获得性肺炎导致急性脑卒中患者病死率明显高于无肺部感染者(26.9%vs 8.0%,P<0.01)。结论重症老年脑卒中患者医院获得性肺炎的感染发生率和病死率均较高,提示在临床工作中应给予重视并加强防护,减少感染发生率。
Objective To study the characteristics of hospital-acquired pneumonia （HAP） in elder- ly cerebral stroke patients receiving intensive care （IC）. Methods Clinical data about HAP in 215 elderly cerebral stroke patients receiving IC in our department were prospectively analyzed. Re- sults The incidence of HAP was 36.3 % in the 215 elderly cerebral stroke patients. Logistic re- gression analysis showed that age 〉 70 years, disturbance of consciousness, dysphagia, smoking and hospital stay time were the risk factors for HAP. The major pathogen of HAP was Gram-neg- ative bacteria （59.8%）, including Acinetobacter Baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli. The mortality（26.9%） was significantly higher in HAP patients than in non HAP patients（P〈0. 01）. Conclusion The incidence of HAP and mortality in elderly patients with severe cerebral stroke are rather high, suggesting that attention should be paid to its treatment in order to reduce its incidence.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2012年第9期965-967,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
广西壮族自治区卫生厅资助课题(Z2009179)
