CAJ | 학술논문

目的：探讨急性脑梗死住院患者医院感染的特征及危险因素。方法回顾性分析122例急性脑梗死住院患者的临床资料，其中感染组33例和非感染组89例，比较2组感染时间、部位、病原菌及病死率。结果感染组平均感染发生在住院后（3．7±1．6）d，感染部位以下呼吸道最多（63．6％），上呼吸道感染6例（18．2％），泌尿系统感染7例（21．2％）。感染组年龄、吞咽困难、意识障碍、留置胃管、留置导尿、美国国立卫生研究院卒中量表（NIHSS）评分、血浆N末端脑钠肽前体、大面积脑梗死比例明显高于非感染组。其中意识障碍和NIHSS评分是急性脑梗死患者医院感染独立的预测危险因素（P＜0．05，P＜0.01）。急性脑梗死住院患者死亡23例，占18．9％，其中感染组死亡18例。剔除死亡因素后，感染组平均住院天数明显多于非感染组[（17．8±4．1）dvs（12．5±5．3）d，P＜0.01]。结论急性脑梗死住院患者医院感染发生率高，应充分重视这些影响因素，减少医院感染的发生率。
목적：탐토급성뇌경사주원환자의원감염적특정급위험인소。방법회고성분석122례급성뇌경사주원환자적림상자료，기중감염조33례화비감염조89례，비교2조감염시간、부위、병원균급병사솔。결과감염조평균감염발생재주원후（3．7±1．6）d，감염부위이하호흡도최다（63．6％），상호흡도감염6례（18．2％），비뇨계통감염7례（21．2％）。감염조년령、탄인곤난、의식장애、류치위관、류치도뇨、미국국립위생연구원졸중량표（NIHSS）평분、혈장N말단뇌납태전체、대면적뇌경사비례명현고우비감염조。기중의식장애화NIHSS평분시급성뇌경사환자의원감염독립적예측위험인소（P＜0．05，P＜0.01）。급성뇌경사주원환자사망23례，점18．9％，기중감염조사망18례。척제사망인소후，감염조평균주원천수명현다우비감염조[（17．8±4．1）dvs（12．5±5．3）d，P＜0.01]。결론급성뇌경사주원환자의원감염발생솔고，응충분중시저사영향인소，감소의원감염적발생솔。
Objective To study the characteristics and risk factors of nosocomial infection in hospi-talized acute ischemic stroke (AIS) patients .Methods One hundred and twenty-two hospitalized AIS patients were divided into nosocomial infection group (n=33) and non-nosocomial infection group (n=89) .Their clinical data were retrospectively analyzed and the infection time ,site ,patho-gens ,mortality were compared .Results Nosocomial infection occurred in patients 3 .7 ± 1 .6 days after admission .The most infection site was lower respiratory tract (63 .6% ) followed by upper respiratory tract (18 .2% )and urinary tract (21 .2% ) .The age was older ,the indidence of dyspha-gia and disturbance of consciousness was higher ,the indwelling time of catheter and gastric tube was longer ,the NIHSS score and the serum NT-proBNP level and the AIS volume were signifi-cantly higher in nosocomial infection group than in non-nosocomial infection group .The disturb-ance of consciousness and NIHSS score were the independent risk factors for nosocomial infection in AIS patients (P<0 .05 ,P<0 .01) .Of the 122 patients ,23 (18 .9% ) died including 18 in nosoco-mial infection group .The average hospital stay time of nosocomial infection group was significant-ly longer than that of non-nosocomial infection group (17 .8 ± 4 .1 d vs 12 .5 ± 5 .3 d ,P<0 .01) . Conclusion The incidence of nosocomial infection is still high in AIS patients .More attention should be paid to the risk factors for nosocomial infection in order to reduce its incidence .