老年慢性卒中相关性肺炎临床特点及预防策略.docVIP

老年慢性卒中相关性肺炎临床特点及预防策略 　　doi：10.3969/j.issn.1007-614x.2014.20.17 　　摘 要 目的：探讨老年慢性卒中相关性肺炎（SAP）相关危险因素、临床特点及预防策略。方法：2009年9月-2012年9月收治老年卒中患者80例，SAP患者40例，为观察组，对照组40例，总结其临床发病因素，分析治疗效果。结果：SAP发生与长期卧床，吞咽困难，高血压、糖尿病病史，意识障碍，气管切开，日常生活能力（ADL）改良Barthel指数评分标准评定60分，鼻胃管，营养不良性低蛋白血症等相关，与对照组比较差异有统计学意义（P0.05），两组治疗结果比较，观察组死亡率高于对照组，差异有统计学意义（P0.05）。结论：老年慢性SPA危险因素较多，多种危险因素共同存在，早期识别，正确诊断，及早干预治疗，降低慢性SAP的发生率与病死率。 　　关键词 老年慢性 卒中 肺炎 　　Clinical characteristics and prevention strategies of elderly chronic stroke associated pneumonia 　　Huang Xinwu 　　Zhangji Coal Mine Hospital of Xuzhou Mining Group Limited Company，Jiangsu 221006 　　Abstract Objective：To explore the related risk factors，clinical characteristics and prevention strategies of elderly chronic stroke associated pneumonia（SAP）.Methods：80 elderly cases with stroke were selected from September 2009 to September 2012.40 cases with SAP were as the observation group.40 cases were the control group.The clinical risk factors were summarized.The treatment effects were analyzed.Results：The occurrence of SAP had the correlation with long-term bedridden，dysphagia，hypertension，diabetes，disturbance of consciousness，tracheotomy，ability of daily life（ADL） reform Barthel index score standard60 scored，nasogastric tube，malnutrition hypoproteinemia and so on.There was significant difference compared with the control group（P0.05）.Compared the treatment outcome of the two groups，the mortality rate of the observation group was higher than that of the control group（P0.05）.Conclusion：Elderly chronic SPA has many risk factors，and a variety of risk factors exist together.Early identification，early diagnosis，intervention treatment as soon as possible can reduce the incidence rate and mortality of chronic SAP. 　　Key words Elderly chronic；Stroke；Pneumonia 　　目前，随着社会老龄化步伐加快，脑血管疾病已成为威胁人类健康的三大主要疾病之一。在临床的老年慢性疾病中，老年慢性卒中是其中比较常见的一种，肺部感染是老年脑卒中患者最常见的并发症，是导致患者病情加重和死亡的重要原因。2003年德国学者HILKER将这种肺炎命名为卒中相关性肺炎（stroke associated pneumonia，SAP）[1]，引起临床医务人员的极大关注和重视。本文对老年卒中相关性肺炎病情特点