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目的探讨分析老年脑卒中患者并发肺部感染的病原学及危险因素,为有效降低老年脑卒中患者发生院内肺部感染提供参考。方法选择2006年7月-2013年7月医院收治的急性脑卒中老年患者325例,采用单因素以及多因素logistic回归分析,对可能影响患者并发肺部感染的各因素进行分析。结果 325例患者中,并发肺部感染患者80例,肺部感染率为24.62%;80例合并肺部感染患者共检出病原菌106株,其中革兰阴性菌75株占70.75%、革兰阳性菌24株占22.64%、真菌7株占6.61%;单因素分析结果显示,年龄、卒中类型、合并基础疾病、意识障碍、吞咽障碍、长期吸烟史、侵入性操作、卧床时间≥14d与老年脑卒中患者肺部感染的发生具有相关性(P<0.05);logistic回归分析显示,合并基础疾病、年龄大、侵入性操作、卧床时间≥14d及意识障碍为影响老年脑卒中患者肺部感染的独立危险因素。结论合并基础性疾病、高龄、侵入性操作、长期卧床以及合并意识障碍是老年脑卒中患者并发肺部感染的独立危险因素,需要引起临床工作者的重视。
Objective To explore the etiology and risk factors of elderly patients with stroke complicated by pulmonary infection and provide a reference for effectively reducing the incidence of nosocomial pulmonary infection in elderly stroke patients. Methods Thirty-five elderly patients with acute stroke who were admitted to our hospital from July 2006 to July 2013 were analyzed by single factor and multivariate logistic regression to analyze the possible influencing factors of pulmonary infection in patients. Results Among the 325 patients, 80 cases were complicated by pulmonary infection, the infection rate of lung was 24.62%. 106 pathogens were detected in 80 patients with pulmonary infection, of which 75 were Gram-negative bacteria, accounting for 70.75%, Gram-positive 24 strains accounted for 22.64%, fungi 7 strains accounted for 6.61%; univariate analysis showed that age, stroke type, with underlying diseases, disturbance of consciousness, swallowing disorders, long-term smoking history, invasive operation, bed rest time ≥ 14d and the brain The incidence of pulmonary infection in stroke patients was correlated (P <0.05). Logistic regression analysis showed that patients with stroke complicated with underlying diseases, older age, invasive procedures, bed rest ≥14 days and unconsciousness were independent factors influencing pulmonary infection in elderly stroke patients Risk factors. Conclusions The combination of basic diseases, advanced age, invasive operation, long-term bed rest and combined with disturbance of consciousness are independent risk factors for pulmonary infection in elderly stroke patients, which needs attention of clinicians.