脑出血患者并发肺部感染的多因素分析

吴开琴; 程晶晶; 卢伟伟; 陈丹

doi:10.16766/j.cnki.issn.1674-4152.002498

脑出血患者并发肺部感染的多因素分析

doi: 10.16766/j.cnki.issn.1674-4152.002498

安徽医科大学合肥第三临床学院(合肥市第三人民医院)神经外科，安徽合肥 230022

基金项目:

安徽省留学回国人员创新创业扶持计划项目 2020LCX016

详细信息

通讯作者:
吴开琴, E-mail: hefeicaoxiao@163.com

中图分类号: R743.34 R563.1
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出版历程
- 收稿日期: 2021-01-20
- 网络出版日期: 2022-09-21

Multivariate analysis of pulmonary infection in patients with cerebral haemorrhage

Neurosurgery Department, Hefei Third Clinical College of Anhui Medical University (the Third People ' s Hospital of Hefei), Hefei, Anhui 230022, China

摘要

摘要: 目的探讨脑出血患者肺部感染发病状况、影响因素及相关干预措施。方法选择2016年1月-2020年11月合肥市第三人民医院住院治疗的脑出血患者207例作为研究对象。根据患者住院期间是否出现肺部感染分为肺部感染组(A组, 91例)和非感染组(B组, 116例)。结合患者人口学资料、病史、病情探讨脑出血并发肺部感染的影响因素。结果脑出血患者出现肺部感染占比43.96%(91/207)。非条件二分类logistic回归分析显示年龄≥65岁(OR=1.102, 95%CI: 1.006~2.135)、COPD病史(OR=2.679, 95%CI: 1.085~6.678)、糖尿病史(OR=3.175, 95%CI: 2.170~4.156)、格拉斯哥昏迷评分(GCS)≤8分(OR=4.500, 95%CI: 3.189~5.865)、手术治疗(OR=8.282, 95%CI: 1.182~31.483)、低蛋白血症(OR=3.864, 95%CI: 1.170~6.696)是脑出血合并肺部感染的独立危险因素。结论脑出血患者肺部感染的发生率较高, 老年患者、合并糖尿病、COPD病史、GCS评分较低、手术治疗及低蛋白血症等因素能独立影响脑出血患者肺部感染的发生, 应针对相关影响因素加强干预, 减少肺部感染的发生, 降低病死率。
- 脑出血 /
- 肺部感染 /
- 影响因素
Abstract: Objective To investigate the incidence, influencing factors and related interventions of pulmonary infection in patients with cerebral haemorrhage. Methods A total of 207 patients with intracerebral haemorrhage who were admitted in our hospital from January 2016 to November 2020 were selected as the research objects.All patients were divided into the pulmonary infection group (group A, n=91) and non-pulmonary infection group (group B, n=116).To explore the influencing factors of cerebral haemorrhage complicated with pulmonary infection, patient demographic data, medical history and condition were analysed. Results The proportion of pulmonary infection in patients with cerebral haemorrhage was 43.96%(91/207).Unconditional binary logistic regression analysis showed that age ≥65 years (OR=1.102, 95%CI: 1.006-2.135), COPD (OR=2.679, 95%CI: 1.085-6.678), diabetes (OR=3.175, 95%CI: 2.170-4.156), GCS≤8(OR=4.500, 95%CI: 3.189-5.865), surgical treatment (OR=8.282, 95%CI: 1.182-31.483) and hypoproteinaemia (OR=3.864, 95%CI: 1.170-6.696) were independent risk factors for cerebral haemorrhage complicated with pulmonary infection. Conclusion Patients with cerebral haemorrhage have a higher incidence of lung infections.Age≥65 years, diabetes, COPD, low GCS score, surgical treatment and hypoproteinaemia can independently affect the occurrence of pulmonary infection in patients with cerebral haemorrhage.Therefore, we should strengthen the intervention according to the relevant influencing factors to reduce the occurrence of pulmonary infection and reduce the mortality rate.
- Cerebral haemorrhage /
- Pulmonary infection /
- Influencing factor

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表 1 脑出血合并肺部感染患者和非肺部感染患者一般情况比较(例)

Table 1. Comparison of general conditions between patients with cerebral hemorrhage complicated with pulmonary infection and patients without pulmonary infection (cases)

组别	例数	性别		年龄≥65岁		吸烟史		COPD史		糖尿病		GCS≤8分
组别	例数	男性	女性	是	否	是	否	是	否	是	否	是	否
A组	91	56	35	50	41	58	33	38	53	21	70	78	13
B组	116	69	47	30	86	56	60	8	108	10	106	62	54
χ²值		0.090		18.191		4.926		35.858		8.370		24.253
P值		0.764		＜0.001		0.026		＜0.001		0.004		＜0.001

组别	例数	出血位置		呕吐		手术治疗		机械通气		鼻饲时间≥5 d		低蛋白血症
组别	例数	脑室出血	非脑室出血	是	否	是	否	是	否	是	否	是	否
A组	91	12	79	70	21	59	32	68	23	71	20	65	26
B组	116	23	93	53	63	27	89	41	75	67	49	53	63
χ²值		1.601		20.631		36.268		31.723		9.422		13.784
P值		0.206		＜0.001		＜0.001		＜0.001		0.002		＜0.001

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表 2 自变量赋值方法

Table 2. Assignment methods of independent variables

自变量	赋值方法
年龄	＜65岁=0，≥65岁=1
糖尿病史	无=0，有=1
吸烟	从不吸烟=0，曾经或现在吸烟=1
COPD病史	无=0，有=1
GCS评分	＞8分=0，≤8分=1
呕吐	无=0，有=1
手术治疗	无=0，有=1
机械通气	无=0，有=1
鼻饲时间	＜5 d=0，≥5 d=1
低蛋白血症	无=0，有=1

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表 3 影响脑出血合并肺部感染发生的多因素logistic回归分析

Table 3. Multivariate logistic regression analysis of influencing the occurrence of cerebral hemorrhage complicated with pulmonary infection

项目	B	SE	Wald χ²	P值	OR值	95% CI
年龄≥65岁	0.097	0.042	5.349	0.021	1.102	1.006~2.135
COPD病史	0.985	0.466	4.468	0.035	2.679	1.085~6.678
糖尿病史	1.155	0.317	5.275	0.003	3.175	2.170~4.156
GCS评分≤8分	1.504	0.487	9.525	0.002	4.500	3.189~5.865
手术	2.114	0.997	4.506	0.034	8.282	1.182~31.483
低蛋白血症	1.352	0.607	4.963	0.026	3.864	1.170~6.696

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