标题：脑梗死合并吸入性肺炎的危险因素及其护理对策

      作者：李晓华 1，孙丽娟 2    宝鸡市人民医院功能科 1、神经内一科 2，陕西 宝鸡 721000

      卷次： 2019年30卷14期

      【摘要】 目的 分析导致脑梗死合并吸入性肺炎的相关危险因素，并探讨其护理对策。方法 选择2015年4月至2018年1月在宝鸡市人民医院接受治疗的60例急性脑梗死患者作为研究对象。以32例已确诊为吸入性肺炎的患者为观察组，28例未确诊为吸入性肺炎的患者作为对照组。所有患者均给予优化的集束化护理，分析影响脑梗死患者吸入性肺炎的危险因素。结果 观察组和对照组患者的误吸史(78.12% vs 35.71%)、老年痴呆(56.25% vs17.84%)、帕金森氏病(81.25% vs 7.14%)、脑卒中(75.00% vs 46.43%)、是否自主进食(84.38% vs 10.71%)以及饮酒患者(65.63% vs 28.60%)比较，观察组明显高于对照组，差异均有统计学意义(P<0.05)。观察组患者出现糖尿病、高血压、低白蛋白血症、吸烟以及尿肌酐水平升高的例数与对照组比较差异均无统计学意义(P>0.05)；多因素Logistic回归分析结果显示，误吸史、老年痴呆、帕金森氏病、脑卒中、自主进食情况以及义齿情况均是脑梗死合并吸入性肺炎的危险因素(P<0.05)；观察组患者死亡17例(53.13%)，明显高于对照组患者死亡2例(7.14%)，差异有显著统计学意义(P<0.01)。结论 误吸史、老年痴呆、帕金森氏病、脑卒中、是否自主进食以及饮酒是脑梗死合并吸入性肺炎的危险因素，对于控制不理想的有基础疾病与反复发生呛咳的患者，可以给予胃管鼻饲处理以防止吸入性肺炎的发生。
      【关键词】 脑梗死；吸入性肺炎；危险因素；护理对策；预后
      【中图分类号】 R473.74 【文献标识码】 A 【文章编号】 1003—6350（2019）14—1902—03

Risk factors and nursing countermeasures of cerebral infarction complicated with aspiration pneumonia.
LIXiao-hua 1, SUN Li-juan 2. Department of Functional Sciences 1, First Department of Neurology 2, Baoji People's Hospital,Baoji 721000, Shaanxi, CHINA
【Abstract】 Objective To study the risk factors of cerebral infarction complicated with aspiration pneumoniaand its nursing countermeasures. Methods Sixty patients with acute cerebral infarction treated in Baoji People's Hospi-tal from April 2015 to January 2018 were selected as the study subjects. Thirty-two patients confirmed as aspirationpneumonia were taken as the observation group, and twenty-eight patients without definite diagnosis or without cerebro-vascular disease were taken as the control group. All patients were given optimized cluster nursing. The risk factors of in-halation pneumonia in patients with cerebral infarction were analyzed. Results Compared with the control group, inha-lation history (78.12% vs 35.71% ), Alzheimer's disease (56.25% vs 17.84% ), Parkinson's disease (81.25% vs 7.14% ),stroke (75.00% vs 46.43%), whether to eat independently (84.38% vs 10.71%) and alcoholic patients (65.63% vs 28.60%)of the observation group was significantly higher (all P<0.05). There were no significant difference in the number of dia-betes, hypertension, hypoalbuminemia, smoking and elevated urinary creatinine levels between the two groups (all P>0.05). Multivariate logistic regression analysis showed that inhalation history, Alzheimer's disease, Parkinson's disease,stroke, self-feeding and denture were all risk factors for cerebral infarction complicated with aspiration pneumonia (P<0.05). There were 17 death cases (53.13%) in the observation group, which was significantly higher than 2 death cases(7.14%) in the control group (P<0.01). Conclusion Inhalation history, Alzheimer's disease, Parkinson's disease, stroke,whether to eat independently and drink alcohol are risk factors for inhalation pneumonia in patients with cerebral infarc-tion. For the patients with underlying diseases and recurrent cough, the treatment of gastric tube nasal feeding can effec-tively prevent the occurrence of inhalation pneumonia.
      【Key words】 Cerebral infarction; Inhalation pneumonia; Risk factors; Nursing strategies; Prognosis·护理·doi:10.3969/j.issn.1003-6350.2019.14.041