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目的探讨急性缺血性脑卒中并发急性肺损伤(ALI)的发生率及临床意义。方法将134例发病48h内入院的ALI患者,按入院7d内有无并发ALI分为2组:ALI组23例,非ALI组111例。观察两组胸部影像、神经功能缺损(如意识障碍、吞咽困难、是否卧床及咳嗽反射减弱)、鼻饲使用情况及入院1周和出院时的死亡率。结果134例急性缺血性脑卒中并发ALI23例(发生率达17.2%);ALI为多因素作用所致,其中与鼻饲、卧床、意识障碍、吞咽困难、咳嗽反射减弱及肺感染程度等有关;ALI组与非ALI组的总死亡率分别为42.5%和18.4%(P<0.01)。结论ALI是老年人急性缺血性脑卒中的常见并发症及死亡原因,临床要引起重视。
Objective To investigate the incidence and clinical significance of acute lung injury (ALI) in acute ischemic stroke. Methods A total of 134 ALI patients admitted within 48 hours of onset were divided into 2 groups according to the presence or absence of concurrent ALI within 7 days after admission: 23 in the ALI group and 111 in the non-ALI group. Two sets of chest radiographs, neurological deficits (eg disturbance of consciousness, difficulty swallowing, decreased bed rest and cough reflexes), nasal feeding use, and 1-week admission and discharge mortality rates were observed. Results 134 cases of acute ischemic stroke complicated with ALI occurred in 23 cases (incidence rate was 17.2%); ALI was caused by multiple factors, including nasal feeding, bed rest, disturbance of consciousness, difficulty swallowing, cough reflex and lung infection, The overall mortality rates in ALI and non-ALI groups were 42.5% and 18.4%, respectively (P <0.01). Conclusion ALI is a common complication and cause of death in elderly patients with acute ischemic stroke.