急诊病房脑卒中相关性肺炎的危险因素及预后分析

doi:10.3969/j.issn.1006-9771.2017.08.013

《中国康复理论与实践》 ›› 2017, Vol. 23 ›› Issue (8): 932-936.doi: 10.3969/j.issn.1006-9771.2017.08.013

急诊病房脑卒中相关性肺炎的危险因素及预后分析

王娜，王丰容，刘芦姗

1.首都医科大学康复医学院，北京市 100068；
2.中国康复研究中心北京博爱医院急诊科，北京市 100068。

收稿日期:2017-05-15 修回日期:2017-07-13 出版日期:2017-08-25 发布日期:2017-08-24
作者简介:王娜(1977-)，女，汉族，河北安国市人，博士，主治医师，主要研究方向：危重症。E-mail: wangnaxxyy@163.com。

Risk Factors and Outcome of Stroke-associated Pneumonia in Emergency Ward　

WANG Na, WANG Feng-rong, LIU Lu-shan

1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China;
2. Emergency Department, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China

Received:2017-05-15 Revised:2017-07-13 Published:2017-08-25 Online:2017-08-24
Contact: WANG Na. E-mail: wangnaxxyy@163.com

摘要/Abstract

摘要： 目的探讨急诊病房中急性脑卒中患者卒中相关性肺炎(SAP)的发生率、危险因素及预后。方法回顾性分析2014年4月至2016年12月本院急诊病房收治的306例急性脑卒中患者的临床资料，将其分为SAP组(n=120)和非SAP组(n=186)，采用Logistic回归分析SAP的危险因素及预后。结果急诊病房中SAP发生率为39.2%，其中34例(28.3%)死亡。两组在年龄、格拉斯哥昏迷评分(GCS)、序贯器官衰竭估计评分(SOFA)和美国国立卫生研究院卒中量表评分(NIHSS)、机械通气、吞咽障碍、抑酸药物使用、鼻饲方面有显著性差异(P<0.05)。Logistic回归分析显示，年龄>65岁、高血压病史、NIHSS评分、GCS<9分、吞咽障碍和抑酸药物使用是SAP发生的危险因素；SOFA评分、NIHSS评分>15分和机械通气是SAP组30 d死亡率的独立危险因素。结论急诊病房中脑卒中患者的SAP发生与多种因素密切相关，并影响其预后。

关键词: 脑卒中, 卒中相关性肺炎, 危险因素, 预后

Abstract: Objective To explore the risk factors and outcome of stroke-associated pneumonia (SAP) in emergency ward. Methods The baseline characteristics and laboratory data of 306 patients with stroke in emergency ward of our hospital from April, 2014 to December, 2016 were reviewed. Patients were allocated into SAP group (n=120) and non-SAP group (n=186). The multivariable Logistic regression was applied to investigate risk factors for the progression and death of SAP. Results Totally, 120 (39.2%) patients developed SAP, in which 34 (28.3%) cases died. There were significant differences in age, the scores of Glasgow Coma Score (GCS), Sequential Organ Failure Assessment (SOFA) and National Institute of Health Stroke Scale (NIHSS), and mechanical ventilation, dysphagia, antiacid and tube feeding (P<0.05). The multivariable Logistic regression analysis revealed that age over 65 years, hypertension, GCS<9, NIHSS, dysphagia and antiacid were the risk factors for the development of SAP; the SOFA, NIHSS>15 and mechanical ventilation were the risk factors for 30-day mortality in SAP group. Conclusion SAP is a severe complication of stroke, it is associated with a variety of risk factors that affect its outcome in emergency ward.

Key words: stroke, stroke-associated pneumonia, risk factors, outcome

中图分类号:

R743.3

王娜，王丰容，刘芦姗. 急诊病房脑卒中相关性肺炎的危险因素及预后分析[J]. 《中国康复理论与实践》, 2017, 23(8): 932-936.

WANG Na, WANG Feng-rong, LIU Lu-shan. Risk Factors and Outcome of Stroke-associated Pneumonia in Emergency Ward　[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2017, 23(8): 932-936.

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急诊病房脑卒中相关性肺炎的危险因素及预后分析

Risk Factors and Outcome of Stroke-associated Pneumonia in Emergency Ward

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