摘要
目的探讨脑梗死患者肺部感染的病原菌分析、临床特点及防治措施,为临床预防及治疗提供思路。方法选取2013年1月-2016年12月于医院神经内科收治的脑梗死患者320例;其中合并肺部感染患者124例为肺部感染组,非肺部感染患者196例为非肺部感染组,患者经影像学诊断明确脑梗死发生部位,进行NIHSS(美国国立卫生院卒中量表)评分、Barthel(日常生活能力评定)评分,行实验室检查比较两组患者白细胞总数(WBC)、血红蛋白(Hb)、急性C-反应蛋白(CRP)、血沉(ESR)、全血高切粘度等指标。结果非肺部感染组NIHSS评分、WBC、全血高切粘度、CRP、ESR均低于肺部感染组,Hb、Barthel高于肺部感染组(P<0.05);脑梗死合并肺部感染患者痰液标本中共检出98份标本微生物,以革兰阴性菌为主,共68株占69.39%。结论大面积脑梗死及多病灶脑梗死患者肺部感染率较高,NIHSS、Barthel评分均与肺部感染风险正相关,而肺部感染病原菌以革兰阴性菌所占比重更大,临床针对此类患者应早期着手监测,关注患者临床体征及实验室指标并采取有效措施以降低脑梗死患者肺部感染发生风险。
OBJECTIVE To investigate pathogen analysis,clinical characteristics and prevention measures of pulmonary infections in patients with cerebral infarction,so as to provide ideas for clinical prevention and treatment.METHODS A total of 320 patients with cerebral infarction in the department of neurology from Zhuji People’s Hospital from Jan.2013 to Dec.2016 were selected.All patients with pulmonary infections were enrolled in this study.Totally 124 patients with pulmonary infections were set as pulmonary infection group,and 196 cases without pulmonary infection were set as non-pulmonary infection group.The patients were diagnosed by imaging to determine the location of cerebral infarction.NIHSS score and Barthel score were carried out.The total white blood cells（WBC）,hemoglobin（Hb）,acute C-reactive protein（CRP）,erythrocyte sedimentation rate（ESR）,blood viscosity and other indicators of the two groups were compared using laboratory examination.RESULTS The NIHSS score,WBC,whole blood viscosity,CRP,and ESR of non-pulmonary infection group were lower than those of pulmonary infection group,and Hb and Barthel score were higher than those of pulmonary infection group（P〈0.05）.Totally 98 specimens of microorganisms were detected from patients with cerebral infarction complicated with pulmonary infections,which were mainly 68 strains of gram-negative bacteria,accounting for 69.39%.CONCLUSIONThe pulmonary infection rates in patients with large area cerebral infarction and multi-lesion cerebral infarction are high,NIHSS and Barthel scores are positively correlated with the risk of pulmonary infections,and the proportion of gram-negative bacteria is larger in colorectal pathogens.Clinical patients should be monitored early,pay attention to clinical signs and laboratory indicators,and take effective measures to reduce the risk of pulmonary infections in patients with cerebral infarction.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第24期5569-5571,5599,共4页
Chinese Journal of Nosocomiology
基金
浙江省医药卫生基金资助项目(2014KYA002)
关键词
脑梗死
肺部感染
临床特点
病原学
Cerebral infarction
Pulmonary infection
Clinical features
Etiology
