急性脑血管疾病并发肺部感染患者的临床特点研究

发布时间：2018-03-24 19:17

  本文选题：急性脑血管疾病　切入点：肺部感染　出处：《中华医院感染学杂志》2017年19期

【摘要】：目的探讨急性脑血管疾病并发肺部感染患者的临床特点。方法选取2014年1月-2016年10月医院收治的急性脑血管疾病并发肺部感染患者68例为感染组,另选择同期住院治疗的急性脑血管疾病非肺部感染患者68例为非感染组,统计患者临床资料,包括年龄、性别、是否接受过侵入性操作、神经功能缺损评分、美国国立卫生研究院卒中量表(NIHSS)评分、格拉斯哥昏迷评分(GCS)、病史、合并症等,并对感染组患者进行病原菌检测。结果感染组患者应用脱水剂、侵入性操作、应用制酸剂、卧床时间、NIHSS评分、神经功能缺损评分、GCS评分、既往肺病史和合并糖尿病均显著高于非感染组患者(P0.05);logistic回归分析结果显示,侵入性操作、NIHSS评分、神经功能缺损评分、GCS评分、既往肺病史和合并糖尿病是急性脑血管疾病并发肺部感染的独立危险因素(P0.05);68例急性脑血管疾病并发肺部感染患者共检出72株病原菌,其中革兰阴性菌46株占63.89%,以肺炎克雷伯杆菌和大肠埃希菌为主;革兰阳性菌18株占25.00%,以金黄色葡萄球菌和肺炎链球菌为主;真菌8株占11.11%。结论急性脑血管疾病并发肺部感染患者病情较重,昏迷较重,合并既往肺病史和合并糖尿病比例高,侵入性操作多,革兰阴性菌是其主要感染病原菌。
[Abstract]:Objective to investigate the clinical characteristics of acute cerebrovascular disease complicated with pulmonary infection. Methods 68 patients with acute cerebrovascular disease complicated with pulmonary infection were selected as infection group from January 2014 to October 2016. 68 non-pulmonary infection patients with acute cerebrovascular disease who were hospitalized at the same time were selected as non-infection group. The clinical data, including age, sex, invasive operation and neurological impairment score, were analyzed. The National Institutes of Health Stroke scale (NIHSS), Glasgow coma scale (Glasgow coma scale), history, complications, etc. The scores of NIHSS, neurological impairment and GCS, history of pulmonary disease and diabetes mellitus were significantly higher than those in non-infection group by logistic regression analysis. The scores of invasive operation and neurological impairment were significantly higher than those of non-infection group. History of pulmonary disease and diabetes mellitus were independent risk factors for acute cerebrovascular disease complicated with pulmonary infection. 72 strains of pathogenic bacteria were detected in 68 patients with acute cerebrovascular disease complicated with pulmonary infection. Among them, 46 Gram-negative bacteria accounted for 63.89um, mainly Klebsiella pneumoniae and Escherichia coli, 18 Gram-positive bacteria accounted for 25.00, mainly Staphylococcus aureus and Streptococcus pneumoniae. Conclusion the patients with acute cerebrovascular diseases complicated with pulmonary infection are more serious, coma is more serious, the proportion of patients with previous lung disease and diabetes mellitus is high, invasive operation is more, Gram-negative bacteria is the main pathogen of infection.
【作者单位】： 晋城市人民医院神经内科;
【分类号】：R563.1;R743.3
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本文编号：1659665