Maeshima Shinichiro, Osawa Aiko, Hayashi Takeshi, Tanahashi Norio
Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Mie, Japan.
Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Aichi, Japan.
J Stroke Cerebrovasc Dis. 2014 Mar;23(3):484-9. doi: 10.1016/j.jstrokecerebrovasdis.2013.04.004. Epub 2013 May 8.
Causative factors for pneumonia and their impact on prognosis were investigated in patients with acute ischemic stroke. Patient characteristics, swallowing function, lesions, and the presence or absence of intervention by dysphagia rehabilitation were assessed in 292 patients with acute cerebral infarction to determine the association of these factors with pneumonia. As a result, 52 patients (17.8%) experienced pneumonia. Of these, 14 developed pneumonia within 3 days of hospital admission and 38 developed the disease after 4 days or later. Pneumonia was frequently seen among elderly patients, those with severe neurological symptoms or cognitive disorders and those with bilateral multiple lesions, and was associated with prolonged length of stay and decline in activities of daily living at hospital discharge. In conclusion, elderly age, bilateral lesions, and severe neurological deficit were significantly associated with pneumonia. Pneumonia in turn strongly predicted inability to take food orally and be discharged from hospital to home.
对急性缺血性中风患者肺炎的致病因素及其对预后的影响进行了调查。评估了292例急性脑梗死患者的患者特征、吞咽功能、病变情况以及吞咽困难康复干预的有无，以确定这些因素与肺炎的关联。结果，52例患者（17.8%）发生了肺炎。其中，14例在入院3天内发生肺炎，38例在4天或更晚发生该病。肺炎在老年患者、有严重神经症状或认知障碍的患者以及双侧多发病变的患者中常见，且与住院时间延长和出院时日常生活活动能力下降有关。总之，高龄、双侧病变和严重神经功能缺损与肺炎显著相关。肺炎反过来又强烈预示无法经口进食和从医院出院回家。
