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选取2013年6月~2014年6月我院神经科收治的107例急性重症脑卒中患者,按照是否合并肺炎将其分为肺炎组51例和非肺炎组56例,观察两组患者的病程、吸烟史、慢性肺疾病史、糖尿病史、意识水平、吞咽功能、脑卒中面积等,并对比两组患者的神经功能缺损评分与病死率。结果(1)病程过长、吸烟史、慢性肺疾病史、糖尿病史、意识障碍、大面积脑卒中等是SAP的独立风险因素,与非肺炎组对比具有统计学意义(P<0.05)。(2)入院时,两组患者的神经功能缺损评分之间无明显差异,不具有统计学意义(P>0.05);入院4w后,肺炎组的神经功能缺损评分明显高于对照组,具有统计学意义(P<0.05)。(3)随访期内,肺炎组的病死率为21.57%(11/51),明显高于对照组10.71%(6/56),具有统计学意义(P<0.05)。病程、吸烟史、慢性肺疾病史、糖尿病史、意识状态与脑卒中面积等是脑卒中患者发生SAP的独立风险因素,患者的病死率较高,会严重影响患者的神经功能与近期预后。
A total of 107 acute severe stroke patients admitted to our department of neurology from June 2013 to June 2014 were divided into pneumonia group (n = 51) and non-pneumonia group (n = 56) Smoking history, history of chronic lung disease, history of diabetes, level of consciousness, swallowing function and stroke area. The neurological deficit score and case fatality rate were compared between the two groups. Results (1) Long course of disease, smoking history, history of chronic lung disease, history of diabetes, disturbance of consciousness, large area stroke were the independent risk factors of SAP, which were statistically significant compared with non-pneumonia group (P <0.05). (2) At admission, there was no significant difference between the two groups in neurological deficit scores (P> 0.05). After 4 weeks of admission, the score of neurological deficit in pneumonia group was significantly higher than that in control group Significance (P <0.05). (3) During the follow-up period, the mortality of pneumonia group was 21.57% (11/51), which was significantly higher than that of the control group (10.71%, 6/56) (P <0.05). The course of disease, the history of smoking, the history of chronic lung disease, the history of diabetes, the state of consciousness and the area of stroke are the independent risk factors of SAP in stroke patients. The high mortality rate of patients will seriously affect the neurological function and short-term prognosis of patients.