金欠欠,吴建贤,张金牛,等.急性颈髓损伤患者继发肺部感染高危因素的回顾性研究[J].中华物理医学与康复杂志,2021,43(11):983-986
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| 急性颈髓损伤患者继发肺部感染高危因素的回顾性研究 |
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| DOI：10.3760/cma.j.issn.0254-1424.2021.11.005 |
| 中文关键词: 颈髓损伤 肺部感染 年龄 高危因素 呼吸道管理 |
| 英文关键词: Spinal cord injury Pulmonary infection Age Risk factors Airway management |
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| 中文摘要: |
| 目的 回顾性分析急性外伤性颈髓损伤患者继发肺部感染的高危因素。 方法 收集符合标准的脊髓损伤患者共154例，获取其病历资料中的性别、年龄、损伤原因、损伤节段、损伤平面和是否合并椎体骨折或脱位等相关临床资料，根据是否发生肺部感染分成对照组120例和病例组34例，对2组患者的临床资料进行单因素分析和Logistic回归分析。 结果 154例患者中，继发肺部感染34例。年龄［比值比（OR）=0.953，95%可信区间（CI）（0.913～0.995）］、美国脊柱损伤学会（ASIA）分级A级［OR=17.013，95%CI（5.187～55.801）］、C4及以上损伤［OR=3.225，95%CI（1.236～8.414）］、损伤至救治时间>8 h［OR=4.010，95%CI（1.447～10.887）］是继发肺部感染的危险因素。 结论 年龄、ASIA分级A级、高位脊髓损伤、损伤至救治时间>8 h是急性外伤性颈髓损伤后继发肺部感染的危险因素，对患者进行高危因素评估并进行早期预防性护理或干预，有望降低其肺部感染发生率，进而减少损伤后的死亡率。 |
| 英文摘要: |
| Objective To analyze retrospectively the risk factors for pulmonary infection after traumatic cervical spinal cord injury. Methods The 154 patients with a cervical spinal cord injury studied included 120 with a pulmonary infection and 34 uninfected controls. Regressions were evaluated using data on their genders, ages, the cause of injury, affected segments, the neurological level of the injury (NLI), and the presence of a vertebral fracture or dislocation. Results Age, complete injury, NLI at C1 to C4, and an injury-to-treatment time of more than 8 hours were found to be independent risk factors for secondary pulmonary infection. Conclusion Elderly spinal cord injury patients, with a complete injury, an NLI between C1 and C4 or an injury-to-treatment time of more than 8 hours have a higher risk of pulmonary infection. |
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