穆景颂,倪朝民,吴鸣,等.康复医学科脑出血患者并发肺部感染危险因素的回顾性研究[J].中华物理医学与康复杂志,2020,42(4):334-338
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| 康复医学科脑出血患者并发肺部感染危险因素的回顾性研究 |
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| DOI：10.3760/cma.j.issn.0254-1424.2020.04.011 |
| 中文关键词: 脑出血 肺部感染 危险因素 |
| 英文关键词: Cerebral hemorrhage Lung infection Risk factors |
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| 中文摘要: |
| 目的 观察康复医学科住院脑出血（ICH）患者并发肺部感染（LI）的危险因素。 方法 选取中国科学技术大学附属第一医院（安徽省立医院）康复医学科收治的ICH患者118例，结合临床表现和肺部影像学检查结果，确诊LI63例，随后将118例患者分为LI组（63例）和非LI组（55例）。记录两组患者的性别、年龄、病程、瘫痪侧别、ICH部位及类型、并发症情况（有无气管切开、尿路感染等）、认知及意识障碍情况、吞咽障碍情况、瘫痪上下肢运动功能等临床资料，并在入院第2日清晨完善血白蛋白、钠、钾、钙、镁等检查。先采用单因素分析，再进行多因素Logistic回归分析，筛选ICH并发LI的危险因素。 结果 单因素分析显示，年龄、病程、瘫痪侧别、出血部位及类型、气管切开、尿路感染、认知障碍、吞咽障碍、上肢和下肢运动功能、血白蛋白、钠、钙、镁可能与ICH患者LI发生有关（P＜0.05）；回归分析显示右侧瘫痪［OR(95%CI)=10.013(1.757，57.052), P=0.009］、双侧瘫痪［OR(95%CI)=17.170(1.092，269.844)，P=0.043］、蛛网膜下腔出血［OR(95%CI)=41.817(1.208，1447.233), P=0.039］、尿路感染［OR(95%CI)=35.274(3.606，345.048), P=0.002］、血镁［OR(95%CI)= 0.000(0.000，0.143), P=0.018］与ICH并发LI有关。 结论 右侧瘫痪和双侧瘫痪、蛛网膜下腔出血、尿路感染是ICH患者并发LI的独立危险因素，血镁水平正常范围内偏高则可减少LI的发生。 |
| 英文摘要: |
| Objective To observe risk factors for lung infection (LI) after cerebral hemorrhage (ICH). Methods A total of 118 patients with ICH were retrospectively analyzed. Among them, 63 were diagnosed with an LI according to clinical manifestations and X-ray or CT on admission. They were selected into an LI group, while the rest formed the non-LI group. Gender, age, duration of disease, side of paralysis, position and type of ICH, complications, cognitive disorders, consciousness, dysphagia, motor function, and serum levels of albumin, sodium, potassium, calcium and magnesium were recorded on the second day after admission. The risk factors for LI were analyzed using univariate and multivariate logistic regression analysis. Results Age, duration of disease, side of paralysis, position and type of ICH, tracheotomy, urinary tract infection, cognitive impairment, dysphagia, motor function, and serum levels of albumin, sodium, calcium, and magnesium were all significant predictors of LI after an ICH. Multivariate logistic regression analysis showed that right side hemiplegia, bilateral paralysis, subarachnoid hemorrhage, urinary tract infection, and serum magnesium are all significant predictors. Conclusions Right or bilateral paralysis, subarachnoid hemorrhage and urinary tract infection are independent risk factors for LI after an ICH. High serum magnesium within the normal range can reduce the incidence of LI. |
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