关键词: 卒中；肺炎；老年；病原学；预后

Abstract:

Objective   To explore the clinical aspects, pathogens, and prognostic factors of senile chronic-onset post-stroke pneumonia． Methods   60 patients with senile chronic-onset post-stroke pneumonia and 60 patients with general senile pneumonia were selected from the total of 340 patients(>65 years old) who were hospitalized in the department of respiratory diseases, the second hospital of Shandong university, from Nov. 2008 to Aug. 2010. All the medical data of the selected patients were collected and compared by a special enrollment, followed by an analysis with SPSS 17.0 software. Results   Compared with general senile pneumonia patients, senile chronic-onset post-stroke pneumonia patients showed much worse general conditions, higher frequency being   accompanied by other diseases, higher blood leukocyte count and lower arterial partial pressure of oxygen. They needed longger hospital stays and had poorer outcome. While, the outcomes of senile chronic-onset post-stroke pneumonia patients who had dysphagia were worse than those who didn’t. Among senile chronic-onset post-stroke pneumonia patients, they were likely to find gram-negtive bacteria at the first sputum cultures, particularly Escherichia coli, followed by pseudomonas aeruginosa, and Klebsiella pneumoniae, while they had higher risk of acquiring gram-positive bacteria and fungi infections.  Both mechanical ventilation and nasal feeding were independent risk factors. Conclusion  Senile chronic-onset post-stroke pneumonia patients have much worse general conditions, test results and prognosis, complexed pathogens.It was necessary to initially choose antibiotics with broad spectrum to cover all the possible pathogens, and the treatment should have sufficient dose and duration. Additionally, the antibiotics with neuroprotective effects were recommended. Mechanical ventilation and nasal feeding are independent risk factors for their outcomes.

Key words: Stroke; Pneumonia; Senile; Pathogen; Prognosis