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目的探讨脑卒中患者肺部感染临床特征及防治措施,为临床诊治提供参考。方法于2008年1月-2012年3月对360例脑卒中患者的临床资料进行回顾性分析,观察肺部感染发生率、痰培养结果、相关因素及对预后影响,采用SPSS13.0软件进行统计分析,计量资料采用t检验,计数资料采用χ2检验。结果 360例脑卒中患者发生肺部感染80例,发生率22.22%;痰培养共分离病原菌60株,其中革兰阴性杆菌32株占53.33%、革兰阳性球菌16株占26.67%,真菌12株占20.00%,排前5位病原菌依次为白色假丝酵母菌、铜绿假单胞菌、金黄色葡萄球菌、大肠埃希菌、表皮葡萄球菌,分别占20.00%、15.00%、13.33%、10.00%、10.00%;患者年龄(61.80±18.89)岁、脱水剂应用(14.12±3.40)d、昏迷、侵入性操作、应用制酸剂、预防应用抗菌药物是发生肺部感染相关因素(P<0.05)。结论脑卒中患者发生肺部感染率高,可延长住院时间、增加病死率,需针对脑卒中患者的生理特点及病理生理改变,采取积极措施减少肺部感染的发生。
Objective To investigate the clinical characteristics and prevention and treatment of pulmonary infection in stroke patients and provide reference for clinical diagnosis and treatment. Methods The clinical data of 360 stroke patients were retrospectively analyzed from January 2008 to March 2012. The incidence of pulmonary infection, sputum culture results, related factors and prognosis were observed. The data were analyzed by SPSS13.0 software Analysis, measurement data using t test, count data using χ2 test. Results The incidence of pulmonary infection in 360 stroke patients was 80 (22.22%). Sixty pathogens were isolated from sputum culture, of which 32 strains were Gram-negative bacilli (53.33%), 16 Gram-positive cocci (26.67%) and 12 Accounting for 20.00%. The top five pathogens were Candida albicans, Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli and Staphylococcus epidermidis, accounting for 20.00%, 15.00%, 13.33% and 10.00% respectively, , 10.00%; age of patient (61.80 ± 18.89) years old, application of dehydrating agent (14.12 ± 3.40) d, coma and invasive operation, application of antacid and antimicrobial agents were the related factors of pulmonary infection (P < . Conclusions Stroke patients have high incidence of pulmonary infection, which can prolong the length of hospital stay and increase the mortality rate. In response to the physiological characteristics and pathophysiological changes of patients with stroke, positive measures should be taken to reduce the incidence of pulmonary infection.