急性脑卒中患者肺部感染的病原菌特点及危险因素分析

发布时间：2018-12-21 12:32

【摘要】：目的探讨急性脑卒中患者肺部感染的病原菌特点及危险因素,以期为控制及降低急性脑卒中患者肺部感染的发生提供参考依据。方法回顾性分析2011年1月-2012年12月208例急性脑卒中患者临床资料,分析肺部感染病原菌特点及危险因素,采取SPSS16.0进行统计分析,计数资料采取χ2检验,多因素分析采取非条件logistic回归分析。结果发生肺部感染的52例肺部感染发生率为25.00%,送检痰液标本培养阳性率为80.77%,检出病原菌共50株,其中革兰阴性菌36株占72.00%,革兰阳性菌12株占24.00%,真菌2株占4.00%,革兰阴性菌主要为肺炎克雷伯菌、鲍氏不动杆菌、铜绿假单胞菌、阴沟肠杆菌,革兰阳性菌主要为金黄色葡萄球菌、表皮葡萄球菌、溶血葡萄球菌;单因素结果分析显示,年龄、糖尿病、侵入性操作、意识障碍、低蛋白血症、住院时间是与肺部感染发生有关的单危险因素(P0.01),非条件logistic回归分析结果显示,年龄大、有侵入性操作、合并糖尿病、有意识障碍、合并低蛋白血症、住院时间长是发生肺部感染的独立危险因素(P0.05)。结论急性脑卒中患者容易发生肺部感染,感染病原菌以革兰阴性菌为主,患者年龄大、有侵入性操作、合并糖尿病、有意识障碍、合并低蛋白血症、住院时间长是引起患者发生肺部感染的独立危险因素。
[Abstract]:Objective to investigate the pathogenic bacteria characteristics and risk factors of pulmonary infection in patients with acute stroke, and to provide a reference for controlling and reducing the incidence of pulmonary infection in patients with acute stroke. Methods the clinical data of 208 patients with acute cerebral apoplexy from January 2011 to December 2012 were retrospectively analyzed. The pathogenic bacteria characteristics and risk factors of pulmonary infection were analyzed. SPSS16.0 was used for statistical analysis and 蠂 2 test was used for counting data. Non-conditional logistic regression analysis was used for multivariate analysis. Results the incidence of pulmonary infection in 52 cases of pulmonary infection was 25.00. The positive rate of culture of sputum samples was 80.77. A total of 50 strains of pathogenic bacteria were detected, of which 36 strains were Gram-negative bacteria (72.00%). There were 12 Gram-positive bacteria (24.00) and two fungi (4.00). Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter cloacae and Gram-positive bacteria were mainly Staphylococcus aureus. Staphylococcus epidermidis, Staphylococcus haemolyticus; Univariate analysis showed that age, diabetes, invasive operation, disturbance of consciousness, hypoproteinemia, length of stay in hospital were the single risk factors associated with pulmonary infection (P0.01). Non-conditional logistic regression analysis showed that age was older. Invasive operation, diabetes mellitus, disturbance of consciousness, hypoproteinemia and long hospital stay were independent risk factors for pulmonary infection (P0.05). Conclusion patients with acute cerebral apoplexy are prone to pulmonary infection. Gram-negative bacteria are the main pathogens of acute stroke. The patients are older, have invasive operation, have diabetes mellitus, have consciousness disorder, and complicated with hypoproteinemia. Long hospital stay is an independent risk factor for pulmonary infection.
【作者单位】：新乡市中心医院干二科;
【基金】：河南省科学技术厅科研基金项目(9412011Y1701)
【分类号】：R563.1

【参考文献】