CAJ | 학술논문

目的：评估使用胃管的卒中急性期患者相关肺炎的发生率、危险因素，以及其与预后的关系。方法：纳入98名使用胃管的卒中急性期伴吞咽困难患者，发病3月后评估功能预后，使用Lo-gistic回归和多元回归分析与肺炎发生及不良预后相关的因素。结果：44.9%患者发生肺炎，大部分肺炎发生于卒中起病后第2或第3天，肺炎患者使用气管插管和机械通气的比例大于未发生肺炎患者，意识水平下降和严重面神经麻痹是肺炎发生的独立预测因子，入院时NIHSS评分是预后的独立预测因子。结论：使用胃管对急性卒中伴吞咽困难所引发的吸入性肺炎的保护作用有限，肺炎主要发生在卒中起病的最初几天，严重意识水平下降和严重面神经麻痹患者是高危人群。
목적：평고사용위관적졸중급성기환자상관폐염적발생솔、위험인소，이급기여예후적관계。방법：납입98명사용위관적졸중급성기반탄인곤난환자，발병3월후평고공능예후，사용Lo-gistic회귀화다원회귀분석여폐염발생급불량예후상관적인소。결과：44.9%환자발생폐염，대부분폐염발생우졸중기병후제2혹제3천，폐염환자사용기관삽관화궤계통기적비례대우미발생폐염환자，의식수평하강화엄중면신경마비시폐염발생적독립예측인자，입원시NIHSS평분시예후적독립예측인자。결론：사용위관대급성졸중반탄인곤난소인발적흡입성폐염적보호작용유한，폐염주요발생재졸중기병적최초궤천，엄중의식수평하강화엄중면신경마비환자시고위인군。
Objective:To estimate the frequency of pneumonia in acute stroke patients fed by nasogas-tric tube, to determine risk factors for this complication, and to examine whether the occurrence of pneumo-nia is related to outcome. Method:A prospective study was done on 98 patients with acute stroke who were given tube feeding because of dysphagia. Functional outcome was assessed at three months. Logistic regres-sion and multivariate regression analysis were used to identify variables significantly associated with the oc-currence of pneumonia and those related to a poor outcome. Result:Pneumonia was diagnosed in 44.9% of the tube fed patients. Most patients acquired pneumonia on the second or third day after stroke onset. Patients with pneumonia more often required endotracheal intubation and mechanical ventilation than those without pneumonia. Independent predictors for the occurrence of pneumonia were a decreased level of consciousness and severe facial palsy. The NIH stroke scale score on admission was the only independent predictor of a poor outcome . Conclusion:Nasogastric tubes offer only limited protection against aspiration pneumonia in patients with dysphagia from acute stroke. Pneumonia occurs mainly in the first day of the illness and patients with de-creased consciousness and a severe facial palsy are especially endangered.