Teramoto Shinji
Department of Pulmonary Medicine, National Hospital Organization, Tokyo National Hospital, Kiyose, Tokyo, 204-8585, Japan.
Expert Rev Neurother. 2009 Aug;9(8):1187-200. doi: 10.1586/ern.09.72.
Pneumonia is a significant complication of ischemic stroke that increases mortality. Post-stroke pneumonia is defined as newly developed pneumonia following stroke onset. Clinically and chronologically, post-stroke pneumonia is divided into two types of aspiration pneumonia. First, acute-onset post-stroke pneumonia occurs within 1 month after stroke. Second, insidious or chronic-onset post-stroke pneumonia occurs 1 month after the stroke. The mechanisms of pneumonia are apparent aspiration and dysphagia-associated microaspiration. Stroke and the post-stroke state are the most significant risk factors for aspiration pneumonia. The preventive and therapeutic strategies have been developed thoroughly and appropriate antibiotic use, and both pharmacological and nonpharmacological approaches for the treatment of post-stroke pneumonia have been studied rigorously. Increases in substance P levels, oral care, and swallowing rehabilitation are necessary to improve swallowing function in post-stroke patients, resulting in a reduction in the incidence of post-stroke pneumonia in a chronic stage. The stroke must be a cause of aspiration pneumonia.
肺炎是缺血性卒中的一种严重并发症，会增加死亡率。卒中后肺炎被定义为卒中发作后新出现的肺炎。从临床和时间顺序上看，卒中后肺炎分为两种类型的吸入性肺炎。第一，急性起病的卒中后肺炎发生在卒中后1个月内。第二，隐匿性或慢性起病的卒中后肺炎发生在卒中1个月后。肺炎的机制是明显的误吸和吞咽困难相关的微量误吸。卒中和卒中后状态是吸入性肺炎最重要的危险因素。预防和治疗策略已经得到充分发展，适当使用抗生素，并且对治疗卒中后肺炎的药理学和非药理学方法都进行了严格研究。提高P物质水平、口腔护理和吞咽康复对于改善卒中后患者的吞咽功能是必要的，从而降低慢性期卒中后肺炎的发生率。卒中必须是吸入性肺炎的病因。
