高血压性基底核区出血并发肺部感染的危险因素研究

目的 探讨高血压性基底核区出血并发肺部感染的流行病学特点和相关危险因素,为高血压性基底核区出血并发肺部感染的防治提供相关科学依据。方法 收集2019年1月至2021年12月我院收治的309 例高血压性基底核区出血患者的临床数据,统计分析肺部感染发生率和病原菌构成比。将纳入的患者依据是否发生肺部感染分为感染组（n=93）和非感染组（n=216）。选取以下变量作为肺部感染的可疑危险因素：年龄、性别、吸烟史、慢性阻塞性肺疾病史、糖尿病史、格拉斯哥昏迷评分、血肿量、血肿清除术、留置胃管和呕吐。采用卡方检验和Logistic回归分析确定高血压性基底核区出血患者并发肺部感染的危险因素。结果 309 例高血压性基底核区出血患者中有93例患者并发肺部感染,感染率为30.1%。痰标本检出病原菌101株,其中革兰阴性菌是最常见的病原菌,占67.33%,主要包括鲍曼不动杆菌、肺炎克雷伯菌和绿脓杆菌;革兰阳性菌占23.76%,主要为金黄色葡萄球菌;真菌占8.91%,包括白色念珠菌和光滑假丝酵母菌。在选取的可疑危险因素中,年龄≥60岁、慢性阻塞性肺疾病史、糖尿病史、吸烟史、呕吐和格拉斯哥昏迷评分≤8是高血压性基底核区出血患者发生肺部感染的独立危险因素。结论 高血压性基底核区出血患者易并发肺部感染,相关危险因素较多,应针对存在的危险因素加强防治,降低肺部感染发生率。

Risk factors of lung infection after hypertensive intracerebral hemorrhage in basal ganglia

Objective To explore the epidemiological characteristics and related risk factors of lung infection in patients with basal ganglia hemorrhage, so as to provide relevant scientific basis for the prevention and treatment of hypertensive basal ganglia hemorrhage complicated with lung infection. Methods The clinical data of 309 patients with hypertensive intracerebral hemorrhage in basal ganglia treated in our hospital from January 2019 to December 2021 were collected. The lung infection rate and the proportion of pathogens were statistically analyzed. The included patients were divided into infection group (n=93) and non-infection group (n=216) according to whether the patient was complicated with lung infection. The following variables were selected as potential risk factors for lung infection: age, gender, smoking history, history of chronic obstructive pulmonary disease, history of diabetes, Glasgow Coma Scale scores, hematoma volume, hematoma removal, indwelling gastric tube and vomiting. The risk factors of lung infection in patients with hypertensive intracerebral hemorrhage in basal ganglia were determined by chi square test and Logistic regression analysis. Results Among 309 patients with hypertensive basal ganglia hemorrhage, 93 patients were complicated with lung infection, and the infection rate was 30.1%. 101 strains of pathogens were detected in sputum samples. Among them, gram-negative bacteria were the most common pathogens, accounting for 67.33%, mainly including Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa; gram positive bacteria accounted for 23.76%, mainly including Staphylococcus aureus; Fungi accounted for 8.91%, including Monilia albican and Candida glabrata. Among the selected potential risk factors, age over 60 years, history of chronic obstructive pulmonary disease, history of diabetes, smoking history, vomiting and Glasgow Coma Scale scores≤8 were independent risk factors of lung infection in patients with hypertensive intracerebral hemorrhage in basal ganglia. Conclusions Patients with hypertensive intracerebral hemorrhage in basal ganglia have a high rate of lung infection. There are many related risk factors for lung infection in these patients. Prevention and treatment should be strengthened according to the existing risk factors to reduce lung infection rate.