急诊重症监护病房重症脑卒中相关性肺炎的危险因素分析

摘要

目的：探讨急诊重症监护病房中急性脑卒中患者卒中相关性肺炎(SAP)的发生率、危险因素分析。方法回顾性分析2012年8月~2013年8月首都医科大学附属北京天坛医院急诊重症监护病房收治的172例急性脑卒中患者的临床资料，将其分为SAP组(n=82)与非SAP组(n=90)。采用Logistic回归分析SAP的危险因素。结果急诊重症监护病房中SAP发生率为47.7%，SAP组与非SAP组患者年龄、吸烟史、心脏病史、糖尿病史、有卒中病史、脑干及小脑卒中、GCS评分、呼吸机应用、鼻饲史、镇静药物应用、制酸剂及预防性抗生素使用比较，差异均有高度统计学意义(P<0.01)；Logistic回归分析显示，高龄、糖尿病、卒中后低GCS评分、呼吸机应用、鼻饲治疗、镇静药物应用、使用胃黏膜保护剂、预防性使用抗生素是SAP的危险因素(P<0.05)。结论急诊重症监护病房中卒中患者的SAP发生与多种因素密切相关，为了降低卒中患者的病死率，需要采取综合措施对导致SAP的因素进行控制。%Objective To explore the risk factors of stroke-associated pneumonia (SAP) in emergency intensive care unit (EICU). Methods The clinical data of 172 patients with stroke in EICU of Beijing Tiantan Hospital, Capital Medical University were retrospectively analyzed,and they were divided into SAP group(n= 82)and non-SAP group(n = 90). The risk factors of SAP were analyzed by Logistic regression. Results 47.7% were suffered SAP, the differ-ences of age, smoking history, heart disease, diabetes mellitus, stroke history, location of stroke, Glasgow coma score, using of mechanical ventilation, tube feeding, using of sedative, antiacid, and antibitic prophylaxis between SAP group and non-SAP group were statistically significant (P< 0.01). Logistic analysis showed that, old, diabetes mellitus, stroke history, location of stroke, low Glasgow coma score, the using of mechanical ventilation, tube feed-ing, the using of sedative, antiacid, and antibitic prophylaxis were the risk factors of SAP (P< 0.05). Conclusion SAP is a severe complications of stroke. In order to reduce the mortality rate of stroke patients, comprehensive mea-sures should be adopted to control stroke-related facts of lung infection.