摘要
目的探讨老年脑卒中患者并发吸入性肺炎的相关危险因素及预后。方法收集2019年1月至2020年6月温州医科大学第二附属医院收治的老年脑卒中患者的临床资料,其中合并吸入性肺炎者为观察组,同期未合并吸入性肺炎者为对照组。采用单因素和多因素logistic回归分析对老年脑卒中患者合并吸入性肺炎的相关危险因素进行筛查,并进一步分析患者预后情况。结果273例符合诊断标准的病例,其中观察组84例(30.77%),对照组189例(69.23%);单因素分析后显示,鼻饲、吞咽困难、体位不当、咳嗽无力、既往脑卒中数、舌头歪斜、咀嚼肌瘫痪、无呕吐反射、NIHSS评分是老年脑卒中并发吸入性肺炎的危险因素(P<0.05);而多元回归分析结果显示,体位不当、吞咽困难、舌头歪斜、无呕吐反射、NIHSS评分是老年脑卒中并发吸入性肺炎的独立危险因素(P<0.05);对照组预后明显优于观察组。结论体位不当、吞咽困难、舌头歪斜、无呕吐反射、NIHSS评分是脑卒中合并吸入性肺炎老年患者的高危因素,且这类患者预后差,制订相应的预防措施以降低吸入性肺炎发生率和改善预后。
Objective To analyze the risk factors and prognosis of aspiration pneumonia in elderly patients with stroke.Methods Clinical data of elderly patients with stroke admitted to the Second Affiliated Hospital of Wenzhou Medical University from January 2019 to June 2020 were collected.Patients complicated with aspiration pneumonia were classified as the observation group,and patients without aspiration pneumonia were classified as the control group.Univariate and multivariate logistic analysis were conducted to screen the risk factors of aspiration pneumonia in elderly patients with stroke,and further analyze the prognosis of patients.Results A total number of 273 patients met the diagnostic criteria,with 84 patients(30.77%)in the observation group and 189 patients(69.23%)in the control group.Nasogastric feeding,dysphagia,improper position,coughing weakness,number of past strokes,tongue skewness,masticatory muscle paralysis,absence of vomiting reflex,and NIHSS score were showed as risk factors for aspiration pneumonia in elderly patients with stroke by univariate analysis.Dysphagia,improper position,skewed tongue,absence of vomiting reflex,and NIHSS score were showed as independent risk factors for aspiration pneumonia in elderly patients with stroke by multivariate logistic regression analysis.The prognosis of the control group was significantly better than that of the observation group.Conclusion Dysphagia,improper position,tongue skewness,absence of vomiting reflex,and NIHSS score are high-risk factors for aspiration pneumonia in elderly patients with stroke.The prognosis of such patients is poor.Corresponding preventive measures should be developed to reduce the incidence of aspiration pneumonia and improve the prognosis.
作者
单慧慧
张青青
黄林敏
李菊芳
郭君怡
SHAN Huihui;ZHANG Qingqing;HUANG Linmin;LI Jufang;GUO Junyi(Department of Rehabilitation,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,China)
出处
《中国现代医生》
2022年第6期182-184,188,共4页
China Modern Doctor
基金
国家自然科学基金项目(71804134)
浙江省温州市科技局课题(Y2020673,Y20210595)。
关键词
脑卒中
吸入性肺炎
危险因素
预后
Stroke
Aspiration pneumonia
Risk factors
Prognosis
