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目的探讨重症脑卒中患者医院获得性肺炎的临床治疗及相关分析。方法 2010年7月至2012年7月期间,我院诊治的142例重症脑卒中患者,其中64例并发医院获得性肺炎,给予相应的抗感染治疗,对其临床资料进行回顾性分析。结果重症脑卒中患者并发医院获得性肺炎的发病率为45.1%,经过相应抗感染治疗后,33例死亡,其死亡率高达51.6%。痰培养结果显示,革兰阴性杆菌感染为主,对第三代头孢、喹诺酮类药物耐药性较严重,而对亚胺培南、β-内酰胺酶抑制剂,以及碳青霉烯类类抗生素相对较为敏感。结论重症脑卒中患者并发医院获得性肺炎的发病率相对较高,合理使用抗生素,有效降低病死率。
Objective To investigate the clinical treatment and related analysis of hospital acquired pneumonia in patients with severe stroke. Methods From July 2010 to July 2012, 142 patients with severe stroke admitted to our hospital, including 64 patients with acquired pneumonia, were given anti-infective therapy. The clinical data were retrospectively analyzed. Results The incidence of nosocomial pneumonia in severe stroke patients was 45.1%. After the corresponding anti-infectives treatment, 33 patients died and the mortality rate was 51.6%. The results of sputum culture showed that Gram-negative bacilli were the main infection, which were more resistant to the third generation cephalosporins and quinolones, but to imipenem, β-lactamase inhibitors and carbapenems Antibiotics are relatively sensitive. Conclusions The incidence of nosocomial pneumonia in patients with severe stroke is relatively high, and rational use of antibiotics can effectively reduce the mortality.