老年急性脑梗死患者肺部感染病原菌特点危险因素及早期神经康复效果OA

Objective To investigate the pathogenic bacteria,risk factors and early neurological rehabilitation effect of pulmonary infection in elderly patients with acute cerebral infarction.Methods A total of 122 elderly patients with acute cerebral infarction in Nanyang First People's Hospital from December 2022 to December 2024 were selected.They were divided into the infection group(40 cases)and the non-infection group(82 cases)based on whether they had developed pulmonary infection.The characteristics of pathogenic bacteria,influencing factors of infection,the predictive value of the nomogram model,and the early neurorehabilitation effect were analyzed.Results A total of 65 pathogenic bacteria were detected in the infection group,including 32 Gram-negative bacteria(49.23%),28 Gram-positive bacteria(43.08%),and 5 fungi(7.69%).The proportion of pathogenic bacteria at 1-2 weeks after onset was the highest.The drug resistance of common pathogenic bacteria was significant.For example,the resistance rate of Escherichia coli to ampicillin was 70%,and the resistance rate of Staphylococcus aureus to penicillin was 85.71%.Logistic regression analysis showed that age,coexisting diabetes,coexisting COPD,and the length of hospital stay were independent risk factors for infection(P<0.05).The nomogram model constructed based on these factors had the AUC of 0.926,with the specificity of 92.68%and the sensitivity of 92.50%.After 8 weeks of treatment,the NIHSS score of the non-infected group was lower,the SF-36 score was higher,and the length of hospital stay was shorter(P<0.05).Conclusion In elderly patients with acute cerebral infarction,pulmonary infections are mainly caused by Gram-negative bacteria,and the drug resistance situation is severe.The nomogram constructed based on age,coexisting diabetes,coexisting COPD and the length of hospital stay has high predictive value.Early rehabilitation can improve the prognosis,the pulmonary infections will delay patient's recovery.Clinicians need to pay attention to infection prevention and control as well as rehabilitation treatment.