本文選題：急性腦血管疾病　切入點：肺部感染　出處：《中華醫(yī)院感染學雜志》2017年19期

【摘要】：目的探討急性腦血管疾病并發(fā)肺部感染患者的臨床特點。方法選取2014年1月-2016年10月醫(yī)院收治的急性腦血管疾病并發(fā)肺部感染患者68例為感染組,另選擇同期住院治療的急性腦血管疾病非肺部感染患者68例為非感染組,統(tǒng)計患者臨床資料,包括年齡、性別、是否接受過侵入性操作、神經(jīng)功能缺損評分、美國國立衛(wèi)生研究院卒中量表(NIHSS)評分、格拉斯哥昏迷評分(GCS)、病史、合并癥等,并對感染組患者進行病原菌檢測。結(jié)果感染組患者應(yīng)用脫水劑、侵入性操作、應(yīng)用制酸劑、臥床時間、NIHSS評分、神經(jīng)功能缺損評分、GCS評分、既往肺病史和合并糖尿病均顯著高于非感染組患者(P0.05);logistic回歸分析結(jié)果顯示,侵入性操作、NIHSS評分、神經(jīng)功能缺損評分、GCS評分、既往肺病史和合并糖尿病是急性腦血管疾病并發(fā)肺部感染的獨立危險因素(P0.05);68例急性腦血管疾病并發(fā)肺部感染患者共檢出72株病原菌,其中革蘭陰性菌46株占63.89%,以肺炎克雷伯桿菌和大腸埃希菌為主;革蘭陽性菌18株占25.00%,以金黃色葡萄球菌和肺炎鏈球菌為主;真菌8株占11.11%。結(jié)論急性腦血管疾病并發(fā)肺部感染患者病情較重,昏迷較重,合并既往肺病史和合并糖尿病比例高,侵入性操作多,革蘭陰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.
【作者單位】： 晉城市人民醫(yī)院神經(jīng)內(nèi)科;
【分類號】：R563.1;R743.3
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本文編號：1659665