孙理信

• 1:河南兰考县人民医院

摘要(Abstract)：

目的探讨卒中相关性肺炎的危险因素及发病机制。方法对87例卒中相关性肺炎的临床资料进行回顾性分析并设立对照组对比。结果 87例SAP患者中64例(73.6%)发生在卒中后1周内。SAP组与非SAP组患者年龄、吸烟史、糖尿病史、脑卒中部位、意识状态评分、鼻饲治疗史、胃黏膜保护剂及预防性抗生素使用史等比较,差异均有统计学意义(P<0.05)。SAP病原菌以革兰氏阴性菌为主(71.7%)。结论 SAP的危险因素是高龄、糖尿病、意识水平低、鼻饲治疗、使用胃黏膜保护剂及预防性使用抗生素。SAP是脑卒中患者病情恶化和死亡的重要原因之一。

关键词(KeyWords)： 卒中相关性肺炎;危险因素

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 孙理信

参考文献(References)：

• [1]Vargas M,Horcajada JP,Obach V,et al.Clinical conse-quences of infectionin patients with acute stroke:ispri me ti mefor further antibiotic trials[J].Stroke,2006,37:461-465.
• [2]Hilker R,Poetter C,Findeisen N,et al.Nosocomial pneumo-nia after acute stroke:i mplications for neurological intensivecare medicine[J].Stroke,2003,34:975.
• [3]中华神经科学会.脑血管疾病分类及治疗诊断[J].中华神经外科杂志,1997,13(1):2.
• [4]Hinchey JA,Shephard T,Furie K,et al.Formal dysphagiascreening protocols preventpneumonia[J].Stroke,2005,36:1 972.
• [5]盛前荣,赵秋红,原永平.脑卒中后合并吸入性肺炎68例痰培养分析[J].中国现代医药杂志,2006,1(8):62-63.
• [6]Kwon HM,Jeong SW,Lee SH,et al.The pneumonia score:asi mple grading scale for prediction of pneumonia after acutestroke[J].AmJ Infect Control,2006,34:64-68.
• [7]Walter U,Knoblich R,Steinhagen V,et al.Predictors ofpneumonia in acute stroke patients admitted to a neurologicalintensive care unit[J].J Neurol,2007,254:1 323.
• [8]张道培,朱奕昕,闫福岭.神经科重症监护病房中急性脑卒中患者死亡危险因素的分析[J].临床神经病学杂志,2008,21:177.
• [9]Mamun K,Li mJ.Role of nasogastric tube in preventing aspi-ration pneumonia in patients with dysphagia[J].SingaporeMed J,2005,46:627
• [10]De Legge MH.Aspiration pneumonia:incidence,mortality,and at risk populations[J].JPEN J Parenter Enteral Nutr,2002,26:19-24.
• [11]Masiero S,Pierobon R,Previato C,et al.Pneumonia instroke patients with oropharyngeal dysphagia:a six-monthfollow-up study[J].NeurolSci,2008,29:139.