重癥腦梗死患者肺部感染的危險因素及病原學(xué)分析
發(fā)布時間:2018-05-10 18:07
本文選題:重癥腦梗死 + 肺部感染; 參考:《中華醫(yī)院感染學(xué)雜志》2017年09期
【摘要】:目的探討有效的防治策略,降低重癥腦梗死患者肺部感染的發(fā)生率,對重癥腦梗死合并肺部感染患者進(jìn)行病原學(xué)分析,并探索影響發(fā)生合并感染的影響因素,為臨床防治提供依據(jù),改善患者的預(yù)后狀況。方法選取2013年6月-2016年6月在醫(yī)院治療的250例重癥腦梗死患者為研究對象,對患者進(jìn)行年齡、性別等一般人口學(xué)特征和高血壓史、糖尿病史、心臟病史、意識障礙等臨床資料收集,進(jìn)行數(shù)據(jù)及影響因素分析。結(jié)果 250例重癥腦梗死患者中,男性占57.6%,平均(58.33±14.96)歲,合并肺部感染的患者有90例,發(fā)生率為36.0%,在90例重癥腦梗死合并肺部感染患者中共分離出118株病原菌,主要為革蘭陰性菌,77株占65.25%,以肺炎克雷伯菌為主,占17.80%,真菌菌株18株占15.25%,以白假絲酵母菌為主,占8.47%,革蘭陽性菌23株,占19.50%;患者年齡、糖尿病史、慢性肺部疾病、住院期間誤吸、吸煙史、意識障礙等與肺部感染的發(fā)生有相關(guān)性(P0.05);年齡≥60歲的患者發(fā)生合并感染的風(fēng)險是60歲的1.81倍;有糖尿病的患者發(fā)生合并感染的風(fēng)險是無的2.33倍;有吸煙史的患者發(fā)生合并感染的風(fēng)險是無的1.76倍;有發(fā)生住院期間誤吸病的患者發(fā)生合并感染的風(fēng)險是無的2.67倍;有意識障礙的患者發(fā)生合并感染的風(fēng)險是無的1.85倍。結(jié)論在患者住院期間應(yīng)根據(jù)病原菌的屬性,選擇合適的抗菌藥物對患者進(jìn)行治療,要同時注意加強(qiáng)對于與感染密切相關(guān)的危險因素的關(guān)注,盡早采取預(yù)防治療措施,減少患者肺部感染的發(fā)生,改善患者癥狀和預(yù)后,提高患者生存質(zhì)量。
[Abstract]:Objective to explore effective prevention and treatment strategies to reduce the incidence of pulmonary infection in patients with severe cerebral infarction, to analyze the etiology of patients with severe cerebral infarction complicated with pulmonary infection, and to explore the influencing factors. To provide the basis for clinical prevention and treatment, improve the prognosis of patients. Methods 250 patients with severe cerebral infarction, who were treated in hospital from June 2013 to June 2016, were studied. The general demographic characteristics, such as age, sex, history of hypertension, history of diabetes, history of heart disease, etc. The clinical data such as consciousness disorder were collected, and the data and influencing factors were analyzed. Results among 250 patients with severe cerebral infarction, male accounted for 57.6 years (mean 58.33 鹵14.96) years old. There were 90 patients with pulmonary infection, the incidence rate was 36.0. 118 pathogenic bacteria were isolated from 90 patients with severe cerebral infarction and pulmonary infection. The main strains were Gram-negative bacteria (65.25), Klebsiella pneumoniae (17.80), fungal strains (15.25%), Candida albicans (8.47%), Gram-positive bacteria (19.50%), age of patients, history of diabetes, chronic lung diseases. The risk of coinfection was 1.81 times in patients with age 鈮,
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