【摘要】 目的探讨脑卒中相关性肺炎(SAP)的危险因素。方法收集2009年1月-2010年9月神经内科住院的脑卒中患者1229例进行统计分析,并与同期心内科住院冠心病并发肺炎患者进行比较。结果 125例脑卒中患者发生SAP,发生率10.17%;其中早发性肺炎71例占56.8%,晚发性肺炎54例占43.2%;与对照组相比,年龄、心脏病、肺部疾病、肿瘤、卧床、意识障碍、吞咽障碍比例在SAP组显著升高,早发性肺炎组心脏病、意识障碍、吞咽障碍比例显著升高,而晚发性肺炎组肿瘤患者比例显著升高;早发性肺炎病原菌前3位依次为肺炎克雷伯菌7株占20.6%,大肠埃希菌6株占17.6%,金黄色葡萄球菌5株占14.7%;晚发性肺炎致病菌前3位依次为肺炎克雷伯菌5株占14.7%,金黄色葡萄球菌4株占11.8%,鲍氏不动杆菌4株占11.8%;与心内科冠心病并发肺炎者相比,SAP组糖尿病、卧床、意识障碍、吞咽障碍比例显著升高;两组间病原菌分布差异无统计学意义。结论 SAP危险因素众多,早发性及晚发性肺炎危险因素不同,卧床、意识障碍、吞咽障碍是SAP独特的危险因素。更多还原

【Abstract】 OBJECTIVE To investigate the risk factors of stroke associated pneumonia(SAP).METHODS A retrospective study was carried out to investigate the clinical data of 1229 stroke patients in department of neurology from Jan 2009 to Sep 2010.Then the clinical risk factors of SAP patients were compared with the coronary heart disease patients with Pneumonia in Department of Cardiology during the same period.RESULTS Totally 125(10.17%) were with SAP,in which early-onset pneumonia(EOP) occurred in 71 patients(56.8%),and late-onset pneumonia(LOP) occurred in 54 patients(43.2%).As compared with the control group in department of neurology,there were statistically significant differences in percentage of age,heart disease,pulmonary disease,tumor,lying in bed,conscious disturbance and dysphagia in SAP group.The patients with heart disease,conscious disturbance,dysphagia and tumor increased the chance of LOP.The first three pathogens were Klebsiella pneumoniae(20.6%),6 strains of Escherichia coli(17.6%),Staphylococcus aureus(14.7%) in EOP;and Klebsiella pneumoniae(14.7%),Staphylococcus aureus(11.8%),Acinetobacter baumannii(11.8%) in LOP.As compared with the coronary heart disease patients with Pneumonia,there were statistically significant differences in percentage of diabetes mellitus,lying in bed,conscious disturbance,dysphagia in SAP group.There were no significant differences in distribution of Pathogens.CONCLUSION There are many risk factors of SAP.The risk factors are different between EOP and LOP.It is suggests that lying in bed,conscious disturbance and dysphagia are the high risk factors of SAP.更多还原