脑梗死患者合并肺部感染相关因素及护理对策

Risk factors and nursing strategies of cerebral infarction complicated with pulmonary infections

    摘要
  • 摘要: 目的 探讨导致脑梗死患者发生肺部感染的相关因素并总结相关护理对策。方法 选取2015年4月-2017年4月医院收治检查后确诊340例脑梗死患者为研究对象进行前瞻性研究,根据护理方式不同分成对照组和试验组,每组170例,试验组实施整体护理对策,对照组给予常规护理干预,比较两组护理干预后住院时间、护理满意度、免疫功能情况及炎性指标水平,观察脑梗死患者并发肺部感染情况,并分析感染相关因素。结果 340例脑梗死患者中,有63例患者发生感染,其感染发生率为18.53%;年龄,GCS评分低、糖尿病史、吸烟史、合并症,抗菌药物使用及激素使用是脑梗死患者合并肺部感染的相关因素(P＜0.05),无菌操作是肺部感染的保护因素(P＜0.05);试验组患者住院时间、C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、IL-8、白细胞(WBC)分别为(12.05±5.56)d、(5.59±2.61)mg/L、(9.53±1.03)ng/L、(7.17±1.43)ng/L、(8.01±2.11)/L均低于对照组(19.96±5.23)d、(7.71±3.37)mg/L、(12.45±1.16)ng/L、(10.59±1.69)ng/L、(10.23±2.57)/L(P＜0.001);试验组护理满意度、CD4、CD8、CD4/CD8分别为94.12%、(37.24±8.03)%、(22.72±7.18)%、(1.67±0.73)优于对照组78.82%、(30.73±8.87)%、(27.18±7.36)%、(1.15±0.58)(P＜0.001)。结论 在脑梗死患者临床治疗及护理工作中,应针对上述相关因素给予相应的护理对策,降低肺部感染发生率,提高临床治疗效果。

     

    Abstract: OBJECTIVE To explore the risk factors of pulmonary infections in patients with cerebral infarction, and to analyze and summarize the relevant nursing strategies. METHODS A total of 340 patients with cerebral infarction diagnosed from Apr. 2015 to Apr. 2017 were selected as the subjects. According to the different nursing methods, they were divided into control group and observation group, with 170 cases in each group. Patients in observation group received holistic nursing, and in control group were given routine nursing intervention. Hospitalization time, nursing satisfaction, immune function and inflammatory markers were compared between the two groups after nursing intervention. The situation of cerebral infarction complicated with pulmonary infections was observed, and the related risk factors were analyzed. RESULTS Among 340 patients with cerebral infarction, 63 patients had postoperative infections, with the infection rate of 18.53%. The incidence of pulmonary infections in patients with cerebral infarction was correlated with age, GCS score, history of diabetes mellitus, history of smoking, complications, and use of antimicrobial agents and hormones(P<0.05), and aseptic operation was the protective factor (P<0.05). The hospitalization time, hs-CRP, IL-6, IL-8 and WBC in observation group were (12.05±5.56) d, (5.59±2.61) mg/L, (9.53±1.03) ng/L, (7.17±1.43) ng/L and (8.01 ± 2.11)/L, which were lower than those in control group(19.96±5.23) d, (7.71±3.37) mg/L, (12.45±1.16) ng/L, (10.59±1.69) ng/L and (10.23±2.57)/L, and the differences were significant (P<0.001). The observation group with the nursing satisfaction, CD4,CD8,CD4/CD8 were 94.12%, (37.24±8.03)%, (22.72±7.18)% and (1.67±0.73), which were significantly better than those in control group78.82%, (30.73 ± 8.87)%, (27.18 ± 7.36)% and (1.15±0.58) (P<0.001). CONCLUSION In the clinical treatment and nursing of patients with cerebral infarction, we should give the appropriate care measures according to the above risk factors to reduce the incidence of pulmonary infections and improve the effect of clinical treatment.

     

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