脑卒中康复期患者肺部感染的病原学特点与危险因素分析

发布时间：2018-03-06 04:33

本文选题：脑卒中　切入点：康复期　出处：《中华医院感染学杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的探讨脑卒中康复期患者肺部感染的病原学特点及危险因素,为临床治疗提供参考依据。方法选择2013年12月-2015年8月因脑卒中收治的患者210例,其中脑出血150例,脑梗死60例,所有患者均经CT或(和)MRI检查后证实;采用回顾性法对研究对象的年龄、性别、体质量、是否合并基础疾病及脑卒中的部位等资料进行分析,并对脑卒中康复期患者肺部感染的病原学特点及危险因素进行分析。结果 210例患者中,74例在康复期发生肺部感染,感染率为35.2%;对康复期74例肺部感染患者痰标本进行细菌培养,检出阳性者58例,阳性率78.4%;分离出病原菌62株,其中革兰阴性菌44株,占71.0%,以肺炎克雷伯菌为主(34.1%),其次为鲍氏不动杆菌(17.7%)和铜绿假单胞菌(17.7%),革兰阳性菌15株占24.2%,以金黄色葡萄球菌为主(12.9%),真菌3株占4.8%;患者的年龄、吸烟史、合并糖尿病、脑卒中部位、意识障碍、侵入性操作以及住院时间等因素与肺部感染的发生具有相关性(P0.05);年龄大、吸烟史、合并糖尿病等基础疾病、脑卒中部位、意识障碍、侵入性操作以及住院时间长是脑卒中患者在康复期肺部感染的主要独立危险因素。结论临床工作中要综合分析脑卒中康复期患者肺部感染的病原菌特点及并发肺部感染的危险因素,提高患者治愈率。
[Abstract]:Objective to investigate the etiological characteristics and risk factors of pulmonary infection in patients with cerebral apoplexy in convalescent period, and to provide reference for clinical treatment. Methods 210 patients with stroke were selected from December 2013 to August 2015, including 150 patients with cerebral hemorrhage. 60 patients with cerebral infarction were confirmed by CT or / or MRI. The age, sex, body mass, underlying diseases and the location of stroke were analyzed retrospectively. The etiological characteristics and risk factors of pulmonary infection in convalescent stroke patients were analyzed. The infection rate was 35.20.The sputum specimens of 74 patients with pulmonary infection in convalescent period were cultured, 58 were positive, the positive rate was 78.4, and 62 strains of pathogenic bacteria were isolated, 44 of which were Gram-negative bacteria. 71.0, mainly Klebsiella pneumoniae, followed by Acinetobacter baumannii 17.7) and Pseudomonas aeruginosa 17.7. Gram-positive bacteria accounted for 24.2%, Staphylococcus aureus as the majority 12.9am, fungi 3 strains 4.80.The patient's age, smoking history, and diabetes, The location of stroke, disturbance of consciousness, invasive operation and length of stay in hospital were correlated with the occurrence of pulmonary infection (P 0.05), age, smoking history, diabetes mellitus and other basic diseases, cerebral apoplexy site, disturbance of consciousness, etc. Invasive operation and length of stay in hospital are the main independent risk factors of pulmonary infection in stroke patients during rehabilitation period. Conclusion in clinical work, we should comprehensively analyze the pathogenic bacteria characteristics of pulmonary infection and pulmonary complications in patients with cerebral apoplexy in convalescent period. Risk factors for partial infection, Improve the cure rate of patients.
【作者单位】：商丘市第一人民医院康复科;
【基金】：河南省医学科技攻关基金资助项目(2013020668)
【分类号】：R563.1;R743.3

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