急性脑血管病患者肺部感染的临床诊断与治疗

发布时间：2018-10-12 13:47

【摘要】：目的探讨急性脑血管疾病肺部感染的病原菌分布、危险因素及耐药性,以期提高临床治疗水平。方法随机选取2011年6月-2013年5月2 765例急性脑血管疾病患者为研究对象,回顾性分析合并肺部感染患者病原菌分布、危险因素及耐药性。结果 2 765例急性脑血管疾病患者中发生肺部感染226例,感染率为8.17%;感染部位以呼吸道和泌尿道为主;共分离出病原菌248株,其中革兰阳性218株占87.90%,革兰阳性菌26株占10.48%,真菌4株,占1.62%;革兰阴性菌对常用抗菌药物耐药率普遍较高,但对亚胺培南、头孢哌酮/舒巴坦、头孢吡肟、阿米卡星仍保持敏感,耐药率15.0%;年龄、侵入性操作、住院时间长、病情严重、营养不良是急性脑血管疾病肺部感染危险因素(P0.05);治愈率为88.94%。结论急性脑血管疾病患者肺部感染发病率较高,对危险因素进行综合管理,重点监控,明确病原菌,根据药敏结果合理用药,可有效降低肺部感染发生率。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria, risk factors and drug resistance in pulmonary infection of acute cerebrovascular disease. Methods A total of 2765 patients with acute cerebrovascular diseases from June 2011 to May 2013 were randomly selected to analyze the distribution of pathogens, risk factors and drug resistance in patients with pulmonary infection. Results among the 2 765 patients with acute cerebrovascular disease, 226 cases had pulmonary infection, the infection rate was 8.17, respiratory tract and urinary tract were the main sites of infection, 248 strains of pathogenic bacteria were isolated. Among them, 218 Gram-positive strains accounted for 87.90%, 26 Gram-positive strains 10.48, and fungi 4 strains, accounting for 1.62.The resistance rate of Gram-negative bacteria to commonly used antimicrobial agents was generally higher, but still sensitive to imipenem, cefoperazone / sulbactam, cefepime, amikacin, and amikacin, but still sensitive to imipenem, cefoperazone / sulbactam, cefepime and amikacin. Drug resistance rate 15.0; Age invasive operation long hospital stay serious condition malnutrition is the risk factor of acute cerebrovascular disease pulmonary infection (P0.05); cure rate is 88.94. Conclusion the incidence of pulmonary infection in patients with acute cerebrovascular diseases is high. Comprehensive management of risk factors, monitoring of the risk factors, identification of pathogenic bacteria and rational use of drugs based on drug sensitivity results can effectively reduce the incidence of pulmonary infection.
【作者单位】：永康市第一人民医院神经内科;
【基金】：金华市卫生局中青年基金资助项目(JW-2010023)
【分类号】：R563.1

【相似文献】