Abstract:

Objective To investigate the influence factors of pulmonary infection (PI) in patients with spontaneous cerebral hemorrhage. Methods A retrospective analysis of clinical data of 228 patients with spontaneous cerebral hemorrhage in Huangshi Central Hospital from June 2015 to June 2018 were performed, to analyze the influence factors of PI in these patients. Results Of 228 patients with spontaneous cerebral hemorrhage, 100 cases (43.67%) had PI, and 148 pathogenic bacteria strains were isolated, including 128 strains (86.48%) of Gram-negative bacteria, 10 strains (6.76%) of Gram-positive bacteria and 10 strains (6.76%) of fungus. The single factor analysis results showed that age, smoking, dysphagia, GCS score, cerebral hemorrhage volume, airway invasive operation, nasal feeding, diabetes, lung diseases, hypoproteinemia were associated with PI after spontaneous cerebral hemorrhage (all P <0.05). The Logistic regression analysis showed that age ≥ 60 years,smoking,dysphagia, GCS score <8, bleeding volume ≥100 mL, airway invasive operation,nasal feeding, diabetes, lung disease, hypoproteinemia were independent risk factors of PI after spontaneous cerebral hemorrhage (P <0.05). Conclusions The incidence of PI after spontaneous cerebral hemorrhage is high, the strains of PI is mainly Gram-negative bacteria. PI occurrence is related with a variety of factors, especially age ≥60 years, smoking, dysphagia, GCS score <8, bleeding volume ≥100 mL, airway invasive operation, nasal feeding, diabetes, lung disease and hypoproteinemia. The patients with the above factors should be given more attention and timely intervention.

Key words: Cerebral hemorrhage; Pulmonary infection; Influence factor; Intervention

摘要：

目的 探讨自发性ICH患者肺部感染（pulmonary infection，PI）的影响因素及其对策。 方法 回顾性分析2015年6月-2018年6月黄石市中心医院收治的228例自发性ICH患者的临床资料， 分析患者PI情况及其影响因素。 结果 228例自发性ICH患者有100例（43.67%）发生PI，共分离病原菌148株，其中革兰氏阴性菌128株 （86.48%）、革兰氏阳性菌10株（6.76%）、真菌10株（6.76%）；单因素分析结果显示，年龄、吸烟、吞 咽困难、GCS评分、出血量、气道侵入性操作、鼻饲、合并糖尿病、肺疾病、低蛋白血症与自发性ICH后 PI发生有关（P＜0.05）；Logistic多元回归分析结果显示，年龄≥60岁、吸烟、吞咽困难、GCS评分＜8分、 出血量≥100 mL、气道侵入性操作、鼻饲、合并糖尿病、肺疾病、低蛋白血症是自发性ICH后PI的独立危 险因素（P＜0.05）。 结论 自发性ICH后PI发生率高，以革兰氏阴性菌感染为主，其发生与多种因素有关，尤其应重视年 龄≥60岁、吸烟、吞咽困难、GCS评分＜8分、出血量≥100 mL、气道侵入性操作、鼻饲、合并糖尿病、 肺疾病、低蛋白血症等患者人群的病情监测与干预。

关键词: 脑出血; 肺部感染; 影响因素; 干预