重症脑梗死患者肺部感染的危险因素及病原学分析

发布时间：2018-05-10 18:07

  本文选题：重症脑梗死 + 肺部感染　； 参考：《中华医院感染学杂志》2017年09期

【摘要】：目的探讨有效的防治策略,降低重症脑梗死患者肺部感染的发生率,对重症脑梗死合并肺部感染患者进行病原学分析,并探索影响发生合并感染的影响因素,为临床防治提供依据,改善患者的预后状况。方法选取2013年6月-2016年6月在医院治疗的250例重症脑梗死患者为研究对象,对患者进行年龄、性别等一般人口学特征和高血压史、糖尿病史、心脏病史、意识障碍等临床资料收集,进行数据及影响因素分析。结果 250例重症脑梗死患者中,男性占57.6%,平均(58.33±14.96)岁,合并肺部感染的患者有90例,发生率为36.0%,在90例重症脑梗死合并肺部感染患者中共分离出118株病原菌,主要为革兰阴性菌,77株占65.25%,以肺炎克雷伯菌为主,占17.80%,真菌菌株18株占15.25%,以白假丝酵母菌为主,占8.47%,革兰阳性菌23株,占19.50%;患者年龄、糖尿病史、慢性肺部疾病、住院期间误吸、吸烟史、意识障碍等与肺部感染的发生有相关性(P0.05);年龄≥60岁的患者发生合并感染的风险是60岁的1.81倍;有糖尿病的患者发生合并感染的风险是无的2.33倍;有吸烟史的患者发生合并感染的风险是无的1.76倍;有发生住院期间误吸病的患者发生合并感染的风险是无的2.67倍;有意识障碍的患者发生合并感染的风险是无的1.85倍。结论在患者住院期间应根据病原菌的属性,选择合适的抗菌药物对患者进行治疗,要同时注意加强对于与感染密切相关的危险因素的关注,尽早采取预防治疗措施,减少患者肺部感染的发生,改善患者症状和预后,提高患者生存质量。
[Abstract]:Objective to explore effective prevention and treatment strategies to reduce the incidence of pulmonary infection in patients with severe cerebral infarction, to analyze the etiology of patients with severe cerebral infarction complicated with pulmonary infection, and to explore the influencing factors. To provide the basis for clinical prevention and treatment, improve the prognosis of patients. Methods 250 patients with severe cerebral infarction, who were treated in hospital from June 2013 to June 2016, were studied. The general demographic characteristics, such as age, sex, history of hypertension, history of diabetes, history of heart disease, etc. The clinical data such as consciousness disorder were collected, and the data and influencing factors were analyzed. Results among 250 patients with severe cerebral infarction, male accounted for 57.6 years (mean 58.33 卤14.96) years old. There were 90 patients with pulmonary infection, the incidence rate was 36.0. 118 pathogenic bacteria were isolated from 90 patients with severe cerebral infarction and pulmonary infection. The main strains were Gram-negative bacteria (65.25), Klebsiella pneumoniae (17.80), fungal strains (15.25%), Candida albicans (8.47%), Gram-positive bacteria (19.50%), age of patients, history of diabetes, chronic lung diseases. The risk of coinfection was 1.81 times in patients with age 鈮，

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