NICU卒中患者相关性肺炎影响因素与病原学分析

发布时间：2018-03-21 20:27

本文选题：卒中　切入点：相关性肺炎　出处：《中华医院感染学杂志》2015年15期 　论文类型：期刊论文

【摘要】：目的了解神经重症监护病房(NICU)卒中患者相关性肺炎(SAP)病原菌分布特征以及SAP发生相关影响因素,为SAP防治提供科学依据。方法前瞻性收集2013年1-12月NICU 317例卒中患者临床资料,其中126例发生SAP,采集感染患者下呼吸道分泌物标本进行细菌培养,数据采用SAS 9.1软件进行统计分析,筛检NICU卒中患者发生SAP的危险因素。结果 126例患者发生SAP,感染率为39.75%;共检出168株病原菌,以革兰阴性菌为主,共125株占74.40%;经logistic回归分析显示,高龄、患糖尿病、吞咽困难、胃管使用、呕吐、意识障碍、呼吸机辅助通气等为发生SAP的独立危险因素(P0.05)。结论 SAP病原菌以革兰阴性菌为主;高龄、胃管使用、呼吸机辅助通气、糖尿病、呕吐、吞咽困难等为影响SAP发生的危险因素,应严密监测SAP病原菌变化,加强防范措施,以减少NICU卒中患者SAP感染的发生。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria and the related factors of SAP in patients with stroke associated pneumonia in neuro-intensive care unit (NICU), and to provide a scientific basis for the prevention and treatment of SAP. Methods the clinical data of 317 stroke patients from January to December 2013 were collected prospectively. Among them, 126 cases of SAP were collected from the samples of lower respiratory tract secretions of infected patients for bacterial culture. The data were analyzed by SAS 9.1 software. Results the incidence rate of SAP was 39.75 in 126 patients with NICU stroke. A total of 168 pathogenic bacteria were detected, mainly Gram-negative bacteria, which accounted for 74.40.The logistic regression analysis showed that the elderly patients had diabetes mellitus and had difficulty swallowing. Gastric tube use, vomiting, disturbance of consciousness and ventilator assisted ventilation were the independent risk factors for SAP. Conclusion Gram-negative bacteria are the main pathogens of SAP, elderly, gastric tube use, ventilator assisted ventilation, diabetes, vomiting, vomiting, and so on. Dysphagia is a risk factor affecting the occurrence of SAP. The changes of pathogenic bacteria in SAP should be closely monitored and preventive measures should be taken to reduce the incidence of SAP infection in patients with NICU stroke.
【作者单位】：东北大学医院内科;抚顺市第三医院内科;中国医科大学附属盛京医院儿科;中国医科大学附属盛京医院神经内科;
【基金】：国家自然科学基金资助项目(81301009)
【分类号】：R743.3;R563.1

【相似文献】