59 Cases Of Inhinhalation Pneumonia In Elderly Stroke And Etiological Study

Objective: Stroke in elderly patients with aspiration pneumonia clinical features and pathogenic features of aspiration pneumonia for elderly stroke prevention and treatment help.Method:In our hospital (Chongqing Ninth People's Hospital) in January 2007 to December 2008 analysis of the results of bacterial culture and in January 2007 to December 2008 in all elderly hospitalized patients with stroke analysis of medical records combined with review survey methods, to understand in January 2007 ~ December 2008 59 patients in our hospital pneumonia in elderly stroke patients with clinical features of inhalation (of all ages based on disease, stroke type and prognosis of consciousness state and other states) and the etiology and resistance drug cases, and analyzed. And different underlying diseases, age, gender, under different clinical prognosis for further analysis of pathogen distribution. Retrospective analysis of 59 cases of elderly patients with aspiration pneumonia clinical data.Results: In elderly patients with aspiration pneumonia after stroke associated with many underlying diseases, higher mortality rate. Hypertension and coronary heart disease in patients with stroke are the first two complications: 46 cases (78%) and 26 patients (44%), in all ages have maintained a relatively high incidence, the prognosis for patients to play crucial role, with hypertension, coronary heart disease patients more than 50% poor prognosis.Data show that not all patients with aspiration pneumonia have consciousness, hemiplegia, and not all patients are coughing, vomiting, cough and fever and other symptoms, insidious onset, cause for concern. Stroke type, age, underlying diseases, consciousness, etc. have significant impact on prognosis.Aspiration pneumonia were Gram negative bacterial infections, fungal infections increased significantly with increasing age, positive bacteria, Gram-negative bacteria and showed a clear downward trend, fungal infections increase in population over the age of 80 as a major pathogen. Death healed group of Gram-positive bacteria was higher than that improving group still aspiration pneumonia in elderly stroke patients with poor prognosis and death of the main pathogens.Comparison of the disease from the base of each group can be seen form the basis of disease pathogens more than the basic similarity, G-ratio> fungi ratio; fungi ratio> G + ratio at 31.71% detection rate of fungi and 45%, and gram-positive bacteria The detection rate of between 8.33% ~ 18.18%, but the COPD group of gram-positive bacteria detection rate was zero, the detection rate of 50% fungi, significantly increased.Klebsiella pneumoniae resistant only to ampicillin sodium, to cephalosporins, imipenem, quinolones are more sensitive. Higher rate of ceftriaxone resistant Pseudomonas aeruginosa, but are more sensitive to other antibiotics. Enterobacter cloacae resistant to most antibiotics, Acinetobacter baumannii, Staphylococcus haemolyticus resistant to common antibiotics higher, but all of the imipenem and levofloxacin against both sensitive. Enterococcus faecalis sensitive to ampicillin effective. Fungi on the 5-fu, itraconazole, fluconazole and most obvious resistance to amphotericin, nystatin most fungi are sensitive.Conclusion:1. Elderly stroke patients with a variety of severe diseases and are often combined, easily lead to coma and other abnormal mental infirmity, hemiplegia, etc., can easily occur aspiration pneumonia, leading to death. Swallowing and cough reflex to establish inspection method of swallowing dysfunction in patients were assessed, using a comprehensive swallowing training measures to strengthen the tongue and masticatory muscle motor function, the re-establishment of the cortical control of swallowing reflex function, improvement or restoration of swallowing function.On the basis of the disease (especially hypertension and coronary heart disease) treatment, and prevention of elderly stroke and aspiration pneumonia incidence and the prognosis is very important.2. Aspiration pneumonia mainly Gram-negative bacteria, fungal infections increased significantly over the age of 80 years the evolution of the main pathogens. Although gram-positive bacteria ratio lower, but a greater impact on prognosis. Generally resistant to common antibiotics higher, and should be based on sputum culture and drug susceptibility test results, reasonable and effective antibiotics. Fiberoptic bronchoscopy, lavage and mechanical ventilation and nutritional support therapy can improve treatment outcomes.