急性卒中后感染特点及危险因素研究.docVIP

急性卒中后感染特点及危险因素研究 　　[摘要] 目的 对急性脑卒中患者住院时发生卒中后感染的特点进行分析，为临床寻找可控危险因素及预防急性卒中后感染提供证据支持。 方法 参照急性卒中后感染的诊断标准连续收集2013年1月1日～2015年12月31日温州市人民医院神经内科住院治疗的604例急性脑卒中患者，对其病历进行数据研究，通过单因素及多因素非条件Logistic回归分析，找出与卒中后感染相关的独立危险因素。 结果 纳入病例中卒中后感染的总感染率为21.2%，主要感染部位为下呼吸道感染（17.9%）、泌尿系感染（3.1%）。多因素非条件Logistic回归分析发现年龄≥65岁、住院期间有侵入性操作、使用镇静类药物、未使用β受体阻滞剂、洼田饮水试验≥3分、NIHSS评分≥15分、ADL评分50分、超敏CRP≥5 mg/L是卒中后感染发生的独立危险因素（P0.05或P0.01）。 结论 卒中后感染发生与多种危险因素相关，临床诊疗决策应当将卒中后感染纳入管理规范，以改善患者近期预后。 　　[关键词] 急性脑卒中；卒中后感染；感染；危险因素 　　[中图分类号] R743.3 [文献标识码] A [文章编号] 1673-9701（2016）36-0005-05 　　[Abstract] Objective To investigate the characteristics of post-stroke infection in hospitalized patients with acute stroke， and to provide evidences for the prevention of acute post-stroke infection and looking for the controllable risk factors. Methods According to the diagnostic criteria of acute post-stroke infection， 604 patients with acute stroke admitted to the Department of Neurology， Wenzhou Peoples Hospital from Jan 1， 2013 to Dec 31， 2015 were included in the study. Univariate and multivariate unconditional Logistic regression analysis to identify independent risk factors associated with post-stroke infection. Results The total infection rate of post-stroke infection was 21.2%. The major infection sites were lower respiratory tract infection （17.9%） and urinary tract infection （3.1%）. Multivariate unconditional Logistic regression analysis found that patients’ age ≥65 years， with invasive procedures during hospitalization， sedative drugs， no β blockers， kubota drinking water test score≥3 points， NIHSS score≥15 points， ADL score50 points and high sensitivity CRP≥5 mg/L were the independent risk factors of post-stroke infection（P0.05 or P0.01）. Conclusion Post-stroke infection is associated with multiple risk factors. Clinical decision-making should incorporate post-stroke infection into management practice to improve short-term prognosis of patients. 　　[Key words] Acute stroke； Post-stroke infection； Infection； Risk factors