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重症监护病房急性脑卒中患者万古霉素耐药肠球菌定植时间延长的预测因素:一项回顾性队列研究。

Predictors of prolonged vancomycin-resistant enterococci colonization in acute stroke patients admitted to an intensive care unit: A retrospective cohort study.

机构信息

Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Republic of Korea.

出版信息

Medicine (Baltimore). 2021 Aug 13;100(32):e26913. doi: 10.1097/MD.0000000000026913.

Abstract

To investigate the factors affecting the duration of vancomycin-resistant enterococci (VRE) colonization in stroke patients.A total of 52 stroke patients with VRE colonization were enrolled. We divided the groups into several factors and confirmed whether each factor affected VRE colonization. Independent t test, bivariate correlation analysis, and Cox proportional hazards model were used to confirm statistical significance.Among 52 patients, 28 were ischemic stroke and 24 were hemorrhagic stroke. The mean duration of the VRE colonization was 39.08 ± 44.22 days. The mean duration of VRE colonization of the ischemic stroke patients was 25.57 ± 30.23 days and the hemorrhagic stroke patients was 54.83 ± 52.75 days. The mean intensive care unit (ICU) care period was 15.23 ± 21.98 days. Independent sample t test showed the hemorrhagic stroke (P < .05), use of antibiotics (P < .01), oral feeding (P < .01) were associated with duration of VRE colonization. Bivariate correlation analysis showed duration of ICU care (P < .001) was associated with duration of VRE colonization. Cox proportional hazard model showed oral feeding (P = .001), use of antibiotics (P = .003), and duration of ICU care (P = .001) as independent factors of duration of VRE colonization.Careful attention should be given to oral feeding, duration of ICU care, and use of antibiotics in stroke patients, especially hemorrhagic stroke patients, for intensive rehabilitation at the appropriate time.

摘要

目的

探讨影响脑卒中患者万古霉素耐药肠球菌(VRE)定植时间的因素。

方法

选取 52 例 VRE 定植的脑卒中患者,分为几组,确认每个因素是否影响 VRE 定植。采用独立 t 检验、双变量相关分析和 Cox 比例风险模型来确认统计学意义。

结果

52 例患者中,缺血性脑卒中 28 例,出血性脑卒中 24 例。VRE 定植的平均时间为 39.08±44.22 天。缺血性脑卒中患者 VRE 定植的平均时间为 25.57±30.23 天,出血性脑卒中患者为 54.83±52.75 天。重症监护病房(ICU)护理时间的平均为 15.23±21.98 天。独立样本 t 检验显示,出血性脑卒中(P<.05)、使用抗生素(P<.01)、经口进食(P<.01)与 VRE 定植时间有关。双变量相关分析显示 ICU 护理时间(P<.001)与 VRE 定植时间有关。Cox 比例风险模型显示经口进食(P=.001)、使用抗生素(P=.003)和 ICU 护理时间(P=.001)是 VRE 定植时间的独立因素。

结论

脑卒中患者,尤其是出血性脑卒中患者,应注意经口进食、ICU 护理时间和抗生素的使用,以便在适当的时候进行强化康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b09c/8360475/1b358ff5bf2e/medi-100-e26913-g001.jpg

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