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目的 探讨脑卒中患者医院获得性肺部感染的特点和防治。方法 对我院1998年1月～2000年12月神经科脑卒中患者中发生的医院感染203例进行回顾性统计分析。结果 出血性脑卒中患者的肺部感染率高于缺血性脑卒中患者,70岁以上高龄患者感染率明显升高,肺部感染多发生在住院两周后,合并感染患者死亡率明显升高;常见病原菌为铜绿假单胞菌、白色念珠菌、嗜麦芽窄食单胞菌、金黄色葡萄球菌（包括MRSA）、产ESBLs菌等,某些病原菌呈多重耐药性。结论 对脑卒中患者,应加强护理,积极采取预防措施,避免发生肺部感染;肺部感染一旦发生,应尽量在使用抗生素前做痰培养和药敏,以便尽早明确病原菌,有针对性地使用敏感的抗生素。
Objective To investigate the characteristics and prevention and treatment of hospital-acquired pulmonary infection in stroke patients. Methods A retrospective statistical analysis was performed on 203 nosocomial infections in neurological stroke patients from January 1998 to December 2000 in our hospital. Results The incidence of pulmonary infection in patients with hemorrhagic stroke was higher than that in patients with ischemic stroke. The infection rate was significantly higher in elderly patients over 70 years old. The incidence of pulmonary infection was mostly two weeks after hospitalization. The mortality rate in patients with complicated infection was significantly higher ; Common pathogens are Pseudomonas aeruginosa, Candida albicans, Stenotrophomonas maltophilia, Staphylococcus aureus (including MRSA), producing ESBLs bacteria, some of the pathogens were multi-drug resistance. Conclusions For patients with stroke, nursing should be strengthened and precautionary measures should be taken actively to prevent the occurrence of pulmonary infection. In case of pulmonary infection, sputum culture and drug sensitivity should be done before use of antibiotics so as to clarify pathogens as soon as possible and use them in a targeted manner Sensitive antibiotics.