脑梗死患者肺部感染特点与多因素logistic回归分析
发布时间：2018-09-01 20:34
【摘要】：目的探讨脑梗死患者伴肺部感染特点,并对相关因素加以分析,为临床防止脑梗死患者发生肺部感染提供参考。方法选取2014年1月-2016年8月医院住院治疗的500例脑梗死患者,将未发生感染的患者作为对照组,发生肺部感染的患者为观察组;对患者临床病例资料、诊治情况等加以分析,对脑梗死患者伴肺部感染发生因素加以分析,并对有统计学意义的单因素行logistic多因素回归分析,同时对感染患者进行痰液培养,了解其病原菌分布。结果 500例脑梗死患者中发生肺部感染32例,感染率为6.4%;经痰液检测发现,32例脑梗死伴肺部感染患者共检出病原菌40株,其中革兰阴性菌28株占70.0%;革兰阳性菌9株占22.5%;真菌3株占7.5%;主要病原菌为铜绿假单胞菌、大肠埃希菌、金黄色葡萄球菌;观察组患者PH值为(7.05±0.02)明显低于对照组(7.51±0.07);PaO_2为(7.98±2.01)KPa明显低于对照组(10.36±0.71)KPa;PaCO_2为(6.19±0.57)KPa明显高于对照组(5.27±0.31)KPa;TNF-α为(0.27±0.02)μg/L明显高于对照组(0.07±0.02)μg/L;IL-6为(0.27±0.14)μg/L明显高于对照组(0.08±0.04)μg/L,以上指标两组比较,差异均有统计学意义(P0.05);单因素分析发现,吸烟、使用呼吸机、气管插管、卧床时间、留置鼻饲管、慢性心功能不全、侵入性操作、意识障碍、年龄、糖尿病、肌力Ⅱ级以下、COPD、球麻痹为脑梗死患者伴肺部感染的影响因素;经多因素logistic回归分析发现,年龄、侵入性操作、气管插管、卧床时间、意识障碍、留置鼻饲管、使用呼吸机、糖尿病、肌力Ⅱ级以下、COPD、球麻痹为脑梗死患者伴肺部感染的高危因素。结论脑梗死患者伴肺部感染的影响因素较多,临床医师需加强对脑梗死患者病情的观察,减少侵入性操作等,制定合理有效防治对策,同时根据病原菌特点积极选择合理抗菌药物,以更好的改善患者预后。
[Abstract]:Objective to explore the characteristics of pulmonary infection in patients with cerebral infarction and analyze the related factors to provide reference for clinical prevention of pulmonary infection in patients with cerebral infarction. Methods 500 patients with cerebral infarction who were hospitalized in hospital from January 2014 to August 2016 were selected as the control group and the patients with pulmonary infection as the observation group, and the clinical data, diagnosis and treatment of the patients were analyzed. The causes of pulmonary infection in patients with cerebral infarction were analyzed, and logistic multivariate regression analysis was performed on the single factor with statistical significance, and sputum culture was carried out to understand the distribution of pathogenic bacteria in the infected patients. Results there were 32 cases of pulmonary infection in 500 patients with cerebral infarction, the infection rate was 6.4%, 40 strains of pathogenic bacteria were detected by sputum examination in 32 cases of cerebral infarction with pulmonary infection. Among them, 28 Gram-negative bacteria accounted for 70.0m, 9 Gram-positive bacteria accounted for 22.5B, 3 fungi accounted for 7.5.The main pathogens were Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus; The PH value of the patients in the observation group was (7.05 卤0.02) significantly lower than that in the control group (7.51 卤0.07) PaO-2 (7.98 卤2.01) KPa was significantly lower than that in the control group (10.36 卤0.71) KPa;PaCO_2 was (6.19 卤0.57) KPa, significantly higher than that in the control group (5.27 卤0.31) KPa;TNF- 伪 (0.27 卤0.02) 渭 g / L was significantly higher than that in the control group (0.07 卤0.02) 渭 g / L IL-6 was (0.27 卤0.14) 渭 g / L significantly higher than that in the control group (0.08 卤0.04) 渭 g / L. Single factor analysis showed that smoking, ventilator, tracheal intubation, bed rest, nasal feeding tube, chronic cardiac insufficiency, invasive operation, disturbance of consciousness, age, diabetes mellitus, Logistic regression analysis showed that age, invasive operation, tracheal intubation, bed-rest time, consciousness disorder, nasal feeding tube, ventilator were used in patients with cerebral infarction. Diabetes mellitus, muscle strength below grade 鈪，
本文编号：2218279
[Abstract]:Objective to explore the characteristics of pulmonary infection in patients with cerebral infarction and analyze the related factors to provide reference for clinical prevention of pulmonary infection in patients with cerebral infarction. Methods 500 patients with cerebral infarction who were hospitalized in hospital from January 2014 to August 2016 were selected as the control group and the patients with pulmonary infection as the observation group, and the clinical data, diagnosis and treatment of the patients were analyzed. The causes of pulmonary infection in patients with cerebral infarction were analyzed, and logistic multivariate regression analysis was performed on the single factor with statistical significance, and sputum culture was carried out to understand the distribution of pathogenic bacteria in the infected patients. Results there were 32 cases of pulmonary infection in 500 patients with cerebral infarction, the infection rate was 6.4%, 40 strains of pathogenic bacteria were detected by sputum examination in 32 cases of cerebral infarction with pulmonary infection. Among them, 28 Gram-negative bacteria accounted for 70.0m, 9 Gram-positive bacteria accounted for 22.5B, 3 fungi accounted for 7.5.The main pathogens were Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus; The PH value of the patients in the observation group was (7.05 卤0.02) significantly lower than that in the control group (7.51 卤0.07) PaO-2 (7.98 卤2.01) KPa was significantly lower than that in the control group (10.36 卤0.71) KPa;PaCO_2 was (6.19 卤0.57) KPa, significantly higher than that in the control group (5.27 卤0.31) KPa;TNF- 伪 (0.27 卤0.02) 渭 g / L was significantly higher than that in the control group (0.07 卤0.02) 渭 g / L IL-6 was (0.27 卤0.14) 渭 g / L significantly higher than that in the control group (0.08 卤0.04) 渭 g / L. Single factor analysis showed that smoking, ventilator, tracheal intubation, bed rest, nasal feeding tube, chronic cardiac insufficiency, invasive operation, disturbance of consciousness, age, diabetes mellitus, Logistic regression analysis showed that age, invasive operation, tracheal intubation, bed-rest time, consciousness disorder, nasal feeding tube, ventilator were used in patients with cerebral infarction. Diabetes mellitus, muscle strength below grade 鈪，
本文编号：2218279
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