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目的分析本院急性脑血管病合并肺部感染患者的相关危险因素,了解发病率、感染部位及病原菌分布,以期为预防感染的发生及感染的后期治疗提供帮助。方法回顾性分析2011年5月—2015年8月在本院诊治1 948例急性脑血管病患者资料,统计分析其中138例其合并肺部感染的发病率、病原菌分布及相关危险因素因素,计数资料采用χ2检验,然后将所有研究的相关危险因素进行多因素Logistic回归分析,P<0.05为差异有统计学意义。结果 1 948例急性脑血管病患者中肺部感染138例,感染率为7.08%;138例送检标本分离出临床病原菌124株,检出率为89.86%;其中革兰阴性杆菌109株,占87.9%;革兰阳性球菌13株,占10.48%;真菌2株,占1.61%;患者患有基础疾病、有侵入性操作、卧床时间≥15 d、意识昏迷、有吸烟史、有饮酒史、存在吞咽障碍、预防性使用抗生素等9项因素是急性脑血管病患者肺部感染的关联因素,对比差异均有统计学意义(均P<0.05);急性脑血管病患者肺部感染的相关影响因素较多,患者年龄大、侵入性操作、意识状态差、吸烟史、使用抗菌药物5个因素为患者肺部感染的独立危险因素。结论感染疾病以脑梗死和脑出血为主,急性脑血管病合并肺部感染病原菌分布广泛,以革兰阴性杆菌感染为主,急性脑血管病合并肺部感染的相关影响因素较多,患者年龄大、侵入性操作、意识状态差、吸烟史、使用抗菌药物5个因素为患者肺部感染的独立危险因素,为减少感染率,需积极采取有效的措施。
Objective To analyze the related risk factors of patients with acute cerebrovascular disease and pulmonary infection in our hospital and to understand the incidence, the location of infection and the distribution of pathogens in order to help prevent the occurrence of infection and the later treatment of infection. Methods The data of 1 488 patients with acute cerebrovascular disease who were diagnosed and treated in our hospital from May 2011 to August 2015 were analyzed retrospectively. The incidence of pulmonary infection in 138 patients, the distribution of pathogens and related risk factors were calculated and counted The data were analyzed by χ2 test, and all relevant risk factors were analyzed by multivariate logistic regression analysis. P <0.05 was considered statistically significant. Results 138 cases of pulmonary infection were found in 1 948 patients with acute cerebrovascular disease and the infection rate was 7.08%. 124 strains of clinical isolates were isolated from 138 samples and the detection rate was 89.86%. Among them, 109 strains of Gram-negative bacilli accounted for 87.9%; Gram-positive cocci 13, accounting for 10.48%; 2 strains of fungi, accounting for 1.61%; patients suffering from underlying diseases, invasive operation, bedridden for 15 days, unconscious, smoking history, There are swallowing disorders, preventive use of antibiotics and other 9 factors in patients with acute cerebrovascular disease associated with pulmonary infection, the differences were statistically significant (P <0.05); pulmonary infection in patients with acute cerebrovascular disease Five factors were considered as independent risk factors of pulmonary infection in patients with more factors, such as older patients, invasive operation, poor consciousness, smoking history and the use of antimicrobial agents. Conclusions The main infectious diseases are cerebral infarction and cerebral hemorrhage. The pathogens of acute cerebrovascular disease complicated with pulmonary infection are widely distributed. Gram-negative bacilli are the main pathogens. There are many influencing factors of acute cerebrovascular disease complicated with pulmonary infection. The patients’ age Large, invasive operation, poor awareness, smoking history, the use of antibiotics, five factors for pulmonary infection in patients with independent risk factors, in order to reduce the infection rate, take active and effective measures to be taken.