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目的评价老年脑血管意外患者全身炎症反应综合征(systemic inflammatory response syndrome,SIRS)评分与发生医院感染及预后的相关性。方法本研究共收集187例神经内科的患者,对患者入院72 h内进行SIRS评分,并对其发生医院感染与预后进行前瞻性统计。结果187例病例中,发生医院感染34例,医院感染发生率18%;死亡23例,死亡率12%;随着SIRS评分增加,医院感染发生率、患者死亡率有增加的趋势(P<0.05)。结论住院超过24 h且SIRS评分≥2分的老年脑血管意外患者应高度警惕医院感染发生的可能性,早期给予相应的干预措施,阻断由SIRS进一步进展到多器官功能衰竭的可能性。SIRS评分系统项目简单,方便操作,为指导临床预测患者的预后提供了又一重要方法,熟练掌握并应用于临床实践中将有助于对患者病情估计和有效诊治,具有良好的临床应用和科研价值。
Objective To evaluate the relationship between systemic inflammatory response syndrome (SIRS) scores and nosocomial infection and prognosis in elderly patients with cerebrovascular accident. Methods A total of 187 neurological patients were collected in this study. SIRS scores were collected within 72 hours after hospital admission and prospective statistics were performed on hospital infection and prognosis. Results Of the 187 cases, nosocomial infection occurred in 34 cases and nosocomial infection rate was 18%. There were 23 deaths and the mortality rate was 12%. As the SIRS score increased, the incidence of nosocomial infections and patient mortality increased (P <0.05 ). Conclusions Elderly patients with cerebrovascular accident who stay in hospital for more than 24 hours with SIRS score ≥2 should be highly alert to the possibility of nosocomial infection. Early intervention should be given to block the possibility of further progression from SIRS to multiple organ failure. SIRS scoring system project is simple and easy to operate, which provides another important method for guiding the clinical prognosis of patients. Proficiency in clinical practice will help to estimate and diagnose the patient’s condition, and has good clinical application and scientific research value.