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目的探讨老年脑卒中相关性肺炎(SAP)的病原菌特点及其危险因素。方法选取在院近期(2015年10月~2016年10月)收治确定诊断的189例老年脑卒中患者,其中有57例患脑卒中相关性肺炎,并称之为SAP组,其余无肺炎诊断患者称之为非SAP组;将2组患者入院后神经功能缺损评分、疾病致死率、临床症状、年龄、脑卒中类型、高血压病史、意识障碍、使用PPI、预防性使用抗生素、鼻饲治疗、性别、有无糖尿病史进行比较,并将SAP患者的痰液进行细菌培养。结果 SAP组神经功能缺损评分明显高于非SAP组(P<0.05);SAP组疾病致死12例(21.05%),非SAP组疾病致死9例(6.82%),2组比较具有明显差异(P<0.05)。57例SAP患者进行痰培养后分离出125株细菌,其中革兰氏阴性菌株71株(56.8%),革兰阳性菌株46株(36.8%)。SAP感染与年龄、脑卒中类型、高血压病史、意识障碍、使用PPI、预防性使用抗生素及鼻饲治疗有关(P<0.05),而与性别、有无糖尿病史无明显关系(P>0.05)。结论老年脑卒中相关性肺炎常常合并多种病原菌感染,此病发生的可能与多种因素有关。
Objective To investigate the characteristics and risk factors of pathogenic bacteria in elderly patients with stroke-associated pneumonia (SAP). Methods A total of 189 senile stroke patients admitted to our hospital from October 2015 to October 2016 were selected. Among them, 57 were stroke-associated pneumonia and were referred to as SAP group. The remaining patients without pneumonia The patients were divided into two groups: non-SAP group, neurological deficit score, disease fatality rate, clinical symptom, age, stroke type, history of hypertension, disturbance of consciousness, PPI use, antibiotic prophylaxis, , Whether there is a history of diabetes, and sputum of SAP patients for bacterial culture. Results The score of neurological deficit in SAP group was significantly higher than that in non-SAP group (P <0.05). In SAP group, 12 cases died of disease (21.05%) and 9 cases (6.82%) died in non-SAP group. There was significant difference between the two groups <0.05). Totally 125 bacteria were isolated from 57 SAP patients after sputum culture, of which 71 (56.8%) were Gram-negative and 46 (36.8%) were Gram-positive. SAP infection was related to age, type of stroke, history of hypertension, disturbance of consciousness, use of PPI, prophylactic use of antibiotics and nasal feeding (P <0.05), but not to gender and diabetes mellitus (P> 0.05). Conclusion Stroke-associated pneumonia in elderly patients is often associated with multiple pathogenic bacteria infections, which may be related to many factors.