Abstract：Objective To discuss the risk factors and nursing countermeasures of pulmonary infection in patients with hypertensive cerebral hemorrhage.Methods Totally 250 patients with hypertensive cerebral hemorrhage were selected from June 2016 to June 2018 in our Hospital, and the concurrent pulmonary infection and its risk factors were analyzed.Results In this study, 100 hypertensive cerebral hemorrhage patients were complicated with pulmonary infection, with the incidence 40.00%, and 150 strains of pathogenic bacteria were isolated, including 10 strains of fungi (6.67%), 20 strains of gram-positive bacteria (13.33%) and 120 strains of gram-negative bacteria (80.00%). Tunivariate analysis showed that, age, smoking, diabetes mellitus, pulmonary diseases, dysphagia, Glasgow coma score, bleeding volume, airway incision, nasal feeding and sedative drug use were related to hypertensive cerebral hemorrhage complicated with pulmonary infection (P<0.05). Logistic multivariate analysis showed that, 60 years old and above, smoking, diabetes mellitus, pulmonary diseases, dysphagia, Glasgow coma score below 8, bleeding over 100 ml, airway incision, nasal feeding and sedative drug use were the independent risk factors for hypertensive cerebral hemorrhage complicated with pulmonary infection (P<0.05).Conclusion The risk of hypertensive cerebral hemorrhage complicated with pulmonary infection is high, the gram-negative bacteria are the main pathogens, and the risk factors are many and complex. We should pay attention to the condition monitoring and nursing intervention of patients with 60 years old and above, diabetes mellitus, pulmonary diseases, dysphagia, Glasgow coma score below 8, bleeding over 100 ml, airway incision, nasal feeding and sedative drug.
[1] JI R, SHEN H, PAN Y, et al. Risk score to predict hospital- acquired pneumonia after spontaneous intracerebral hemorrhage[J]. Stroke,2014,45(9):2620-2628. [2] 林君,林云,徐超.综合康复训练对脑卒中气管切开术后患者肺部感染发生率及肺功能的影响[J].健康研究,2018,38(4):462-463. [3] 林宝丽,王文浩,郁毅刚.高血压脑出血并发院内肺部感染的危险因素及其对预后的影响[J].东南国防医药,2014,16(2):194-196. [4] DENES A,PRADILLO JM,DRAKE C,et al.Streptococcus pneumoniae worsens cerebral ischemia via interleukin 1and platelet glycoprotein Ibα[J].Ann Neurol,2014,75(5):670-683. [5] 中华医学会神经病分会.中国脑血管病防治指南[M].北京:卫生部疾病控制司,2010:86. [6] 中华人民共和国卫生部.医院感染诊断标准(试行)[J].中华医学杂志,2001,81(5):314-320. [7] DIVANI AA, HEVESI M, PULIVARTHI S, et al. Predictors of nosocomial pneumonia in intracerebral hemorrhage patients: a multi-center observational study [J]. Neurocrit Care, 2015,22(2):234-242. [8] 刘爱翠,马巧丽,王妍柏,等.脑出血合并肺部感染的相关危险因素分析[J].宁夏医科大学学报,2015,37(1):36-38. [9] RODRIGUEZ-SERRANO DA, LEAL-MICHARET A, Rajas O, et al.Use of recombinant activated factor vii in bronchoalveolar lavage in a case of pulmonary hemorrhage[J].Med Intensiva,2015,39(4):253-5. [10]廖晓悦.高血压脑出血合并肺部感染的相关因素分析[J].中国医院统计,2017,24(6):417-420. [11]张秀英,陈禄芝,杨再良,等.脑出血患者肺部感染的危险因素分析[J].中华医院感染学杂志,2014,24(6):1416-1417. [12]LORD AS, LANGEFELD CD, SEKAR P,et al.Infection after intracerebral hemorrhage: risk factors and association with outcomes in the ethnic/racial variations of intracerebral hemorrhage study.[J].Stroke, 2014,45(12):3535-42. [13]徐成年.进展性出血脑卒中并发肺部感染的相关因素分析[J].中国医院统计,2018,25(3):212-214. [14]冯阳,张超,文泽贤,等.基底节区脑出血并发肺部感染的危险因素分析[J].重庆医学,2016,45(7):890-892. [15]KALIL AC, METERSKY ML, KLOMPAS M, et al. Executive summary: management of adults with hospital-acquired and ventilator- associated pneumonia: 2016 clinical practice guidelines by the infectious diseases society of America and the American Thoracic Society[J]. Clin Infect Dis,2016,63(5):575-582.
