【摘要】：目的探討老年腦卒中假性球麻痹致肺部感染的病原學特點,為臨床用藥提供指導。方法選擇神經(jīng)內(nèi)科卒中單元病房2012年1月-2013年1月21例老年腦卒中假性球麻痹致肺部感染患者作為研究對象進行回顧性分析,統(tǒng)計數(shù)據(jù)采用SPSS 13.0進行處理。結(jié)果 21例老年腦卒中假性球麻痹致肺部感染患者檢出病原菌22株,以革蘭陰性菌為主占68.2%;前5位的病原菌為肺炎克雷伯菌、銅綠假單胞菌、大腸埃希菌、鮑氏不動桿菌、金黃色葡萄球菌,分別占27.3%、13.6%、13.6%、9.1%、9.1%;泛耐藥鮑氏不動桿菌僅對亞胺培南、萬古霉素較敏感,對其他抗菌藥物100.0%耐藥;21例患者經(jīng)積極治療后,19例患者的感染在5~8d內(nèi)得到控制,死亡2例,均死于腦卒中伴多器官功能衰竭,病死率9.52%。結(jié)論老年腦卒中假性球麻痹后容易并發(fā)肺部感染,針對感染病原菌,足量、早期、聯(lián)合使用敏感抗菌藥物,同時積極治療原發(fā)病,加強多頻振動排痰、營養(yǎng)支持、吞咽困難篩查和吞咽功能訓練等是控制感染,降低病死率的有效方法。
[Abstract]:Objective to investigate the etiological characteristics of pulmonary infection caused by pseudobulbar paralysis in elderly stroke and to provide guidance for clinical drug use. Methods 21 elderly patients with pulmonary infection caused by pseudobulbar paralysis from January 2012 to January 2013 in stroke unit ward of Department of Neurology were selected as subjects for retrospective analysis. The statistical data were treated with SPSS 13.0. Results 22 strains of pathogenic bacteria were detected in 21 elderly patients with pseudobulbar paralysis caused by pseudobulbar paralysis. Gram-negative bacteria accounted for 68.2%. The top five pathogens were Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, Acinetobacter baumannii and Staphylococcus aureus, accounting for 27.3%, 13.6%, 9.1% and 9.1%, respectively. Pan-resistant Acinetobacter baumannii was only sensitive to imipenem, vancomycin and 100.0% to other antibiotics. After active treatment, the infection of 19 patients was controlled within 5 鈮，

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