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目的分析收住卒中单元和神经内科普通病房急性脑卒中合并感染病例的治疗与转归。方法回顾性分析急性脑卒中后合并感染(肺部/尿路感染)患者165例,其中卒中单元组67例,普通病房组98例。分析两组感染特点及病原体检查结果。评价两组患者的转归:1主要转归为90 d病死率;2次要转归为第21天NIHSS评分和90d改良Rank(m RS)评分。比较两组患者的营养不良发生率、住院天数和药占比。结果两组患者均以合并肺部感染为主,感染病原体均以革兰阴性杆菌为主。卒中单元组90 d病死率明显低于普通病房组(P=0.009);第21天NIHSS评分和90 d m RS评分均显著优于普通病房组(均P=0.000)。卒中单元组营养不良发生率显著低于普通病房组(P=0.000)。卒中单元组住院天数和药占比均低于普通病房组,差异有显著统计学意义(P=0.000)。结论相对于普通病房,卒中单元在减少住院天数和药品费用的前提下,能降低脑卒中住院患者的病死率,提高患者神经功能恢复。
Objective To analyze the treatment and prognosis of patients with acute stroke complicated with stroke unit and neurology general ward. Methods A retrospective analysis of 165 patients with acute infection after stroke (pulmonary / urinary tract infection), including stroke unit 67 cases, general ward 98 cases. Analysis of two groups of infection characteristics and pathogen examination results. The outcomes of the two groups were evaluated: 1 The primary outcome was 90-day mortality; the secondary outcome was the NIHSS score on day 21 and the m-RS score on 90th day. The incidence of malnutrition, length of hospital stay, and medication were compared between the two groups. Results Both groups of patients were mainly associated with pulmonary infection, and pathogens were mainly Gram-negative bacilli. The 90-day mortality rate was significantly lower in the stroke unit than in the general ward group (P = 0.009). The NIHSS score and 90-day mRS score on day 21 were significantly better than those in the general ward group (both P = 0.000). The incidence of malnutrition in the stroke unit group was significantly lower than in the general ward group (P = 0.000). Stroke unit hospital days and the proportion of medicine were lower than the ward general group, the difference was statistically significant (P = 0.000). Conclusion Compared with general ward, stroke unit can reduce the mortality rate of inpatients with stroke and improve the recovery of neurological function in patients with reduced hospitalization days and medication costs.