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目的对急性脑卒中并发肺部感染的病原菌谱及相关危险因素进行统计分析,寻求预防急性脑卒中患者并发肺部感染的科学方法。方法收集统计2010年5月至2014年5月在我院住院治疗的298例急性脑卒中患者并发肺部感染患者的病原菌谱的检出情况,回顾性分析相关危险因素。结果 298例急性脑卒中患者合并肺部感染93例,感染率为31.20%,共分离病原菌108株,其中真菌21株,占19.44%,革兰氏阳性菌32株,占29.63%,革兰氏阴性菌55株,占50.93%;以铜绿假单胞菌、金黄色葡萄球菌、白色假丝酵母菌较为常见。急性脑卒中并发肺部感染与患者年龄、发病时间、住院时间、脑卒中史、慢性肺病、意识障碍、卒中类型、糖尿病、长期吸烟、低蛋白血症、肾功能不全、卧床时间、侵入性操作、免疫疾病等因素密切相关(P<0.01),而与性别、吞咽困难、高血压、高血脂、心力衰竭、合并冠心病无密切相关性(P>0.05)。结论医院急性脑卒中并发肺部感染受多种因素的影响,病原菌谱为革兰氏阴性菌多见,要预防急性脑卒中并发肺部感染必须采取多种综合干预措施。
Objective To analyze the pathogenic bacteria spectrum and associated risk factors of acute stroke complicated with pulmonary infection and to find a scientific method to prevent pulmonary infection in patients with acute stroke. Methods A total of 298 patients with acute stroke who were hospitalized in our hospital from May 2010 to May 2014 were enrolled in this study. Pathogenic bacteria were collected from patients with pulmonary infection and the related risk factors were analyzed retrospectively. Results A total of 298 acute stroke patients were infected with pulmonary infection, the infection rate was 31.20%. A total of 108 pathogens were isolated, of which 21 were fungi, accounting for 19.44%, 32 were Gram-positive bacteria, accounting for 29.63% 55 negative bacteria, accounting for 50.93%; Pseudomonas aeruginosa, Staphylococcus aureus, Candida albicans more common. Acute stroke complicated with pulmonary infection was associated with age, onset time, length of hospital stay, history of stroke, chronic lung disease, disturbance of consciousness, stroke type, diabetes mellitus, chronic smoking, hypoproteinemia, renal insufficiency, bed rest time, invasive procedure , Immune diseases and other factors (P <0.01), but not with gender, dysphagia, hypertension, hyperlipemia, heart failure and coronary heart disease (P> 0.05). Conclusions Acute stroke complicated with pulmonary infection in hospitals is affected by many factors. The pathogenic bacteria spectrum is more common with Gram-negative bacteria. To prevent acute stroke complicated with pulmonary infection, a variety of comprehensive intervention measures must be taken.