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目的探讨老年脑卒中患者急性期并发呼吸道感染的高危因素及治疗方法,以期提高临床对老年脑卒中急性期并发呼吸道感染的认识水平,提高该类患者的治疗质量。方法选取老年急性脑卒中患者1 983例,将并发呼吸道感染的97例患者随机分为对照组和观察组,分别为48、49例,对照组实施常规治疗,观察组实施支气管肺泡灌洗治疗,对两组患者治疗效果进行评价和比较。结果 1 983例患者共发生肺部感染97例,感染率为4.89%;患者年龄≥70岁、有脑卒中病史、慢性肺病史、意识障碍、吞咽障碍、合并糖尿病、合并低蛋白血症、合并肾功能不全、有侵入性操作、住院时间≥3周是老年脑卒中急性期并发呼吸道感染的相关危险因素(P<0.05);治疗后显效率和总有效率观察组分别为53.06%和87.76%,对照组分别为20.83%和56.25%,两组比较差异有统计学意义(P<0.05)。结论老年脑卒中急性期患者并发呼吸道感染与多种因素密切相关,临床工作中对这部分患者应给予适当的预防干预,通过支气管肺泡灌洗治疗可改善预后。
Objective To investigate the risk factors and treatment of respiratory tract infections in elderly stroke patients in acute stage in order to improve the clinical awareness of acute respiratory tract infection in stroke patients and to improve the quality of treatment. Methods A total of 1 983 elderly patients with acute stroke were enrolled in this study. 97 patients with respiratory tract infection were randomly divided into control group and observation group, with 48 and 49 cases respectively. The control group received routine treatment and the observation group received bronchoalveolar lavage. The treatment effect of two groups of patients were evaluated and compared. Results A total of 1 983 cases of pulmonary infection occurred in 97 cases, the infection rate was 4.89%; patients aged 70 years or older had a history of stroke, history of chronic lung disease, disturbance of consciousness, swallowing, diabetes mellitus, hypoproteinemia, Renal insufficiency, invasive operation, hospitalization ≥3 weeks were the risk factors associated with respiratory tract infection in the acute stage of senile stroke (P <0.05). The effective rate and total effective rate in observation group after treatment were 53.06% and 87.76% , The control group were 20.83% and 56.25% respectively, with significant difference between the two groups (P <0.05). Conclusion Acute respiratory tract infection in elderly patients with acute stroke is closely related to various factors. Appropriate preventive intervention should be given to this part of patients in clinical practice. Bronchial alveolar lavage can improve prognosis.