庄景义,韦薇,周莉莉,詹克栋
ZHUANG Jingyi,WEI Wei,ZHOU Lili,ZHAN Kedong

• 1:贵州省肿瘤医院急诊科

摘要(Abstract)：

目的:分析老年急性缺血性脑卒中并发卒中相关性肺炎(SAP)的相关影响因素。方法:58例老年(≥65岁)急性缺血性脑卒中并发SAP患者作为观察组,同期60例急性缺血性脑卒中未发生SAP患者作为对照组,比较2组患者的人口学资料(年龄、性别、职业、居住地等)、病情相关资料[吸烟史、饮酒史、吞咽障碍、肢体偏瘫、美国国立卫生研究院卒中量表(NIHSS)评分、Glasgow昏迷评定量表(GCS)评分、合并房颤、合并冠心病、合并糖尿病等]及医疗措施(行机械通气、肠内营养时长),对有统计学意义的指标行多因素Logistic回归分析,分析影响老年急性缺血性脑卒中并发SAP的高危因素。结果:单因素分析结果显示,2组患者年龄、吸烟史、饮酒史、吞咽障碍、肢体偏瘫、NIHSS评分、GCS评分、合并房颤、合并冠心病、合并糖尿病、行机械通气、肠内营养时长比较,差异有统计学意义(P<0.05);多因素Logistic分析结果显示,年龄≥75岁、有吸烟史、NIHSS≥15分、有吞咽障碍、有肢体偏瘫、GCS评分≤11分、合并房颤、合并冠心病、行机械通气、肠内营养时长≥1周是老年急性缺血性脑卒中并发SAP的高危因素。结论:老年急性缺血性脑卒中并发SAP影响因素以自身病情为主,其次还受到医疗因素影响。
Objective: To analyze the related factors of stroke-associated pneumonia(SAP) in elderly patients with acute ischemic stroke(AIS). Methods: From March 2017 to March 2018, 58 elderly patients with AIS complicated with SAP were enrolled as the observation group, and 60 elderly patients(≥65)served as the control group. The demographic data, illness data and medical measure data of the two groups were compared and analyzed, and multivariate logistic analysis was used to determine the related risk factors, and to explore the measures to prevent SAP in elderly patients with AIS. Result: Univariate correlation analysis showed that the factors influencing SAP in elderly patients with AIS were age, smoking history, drinking history, dysphagia, limb hemiplegia, NIHSS scores, GCS scores, atrial fibrillation, coronary heart disease, diabetes mellitus, mechanical ventilation, duration of enteral nutrition(P<0.05). Multivariate Logistic analysis showed that age(≥75 years old), smoking history, NIHSS(≥15), dysphagia, limb hemiplegia, GCS scores(≤11), atrial fibrillation, coronary heart disease, mechanical ventilation, enteral nutrition duration(≥1 week) were the high risk factors for SAP of elderly patients with AIS.Conclusion: The physical condition of elderly patients with AIS is generally poor. The main factors affecting SAP are the patients' own condition, and medical factors as well. The comprehensive situation of the patients should be comprehensively assessed, the advantages and disadvantages of the physical condition should be weighed. The medical measures should be carefully formulated to reduce the incidence of AIS and SAP.

关键词(KeyWords)： 脑卒中,急性,缺血性;老年人;肺炎,卒中相关性;高危因素
stroke,acute,ischemic;elderly people;pneumonia,stroke-associated;high-risk factors

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目(81860248)

作者(Author): 庄景义,韦薇,周莉莉,詹克栋
ZHUANG Jingyi,WEI Wei,ZHOU Lili,ZHAN Kedong

DOI: 10.19367/j.cnki.1000-2707.2019.11.019

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