Correlation Analysis Pneumonia And Intractable Status Epilepticus

Objective:For the treatment of status epilepticus the various stages have been clearly optimal treatment protocol. Study due to multiple organ dysfunction caused by intractable status epilepticus also increasingly deepened. Lung infections become ICU, mechanical ventilation, nursing the most major work, and the most difficult to control.This article is a single-center, short-term cohort study to examine relevance of the intractable status epilepticus pulmonary infection risk factors.Method:Collect Shenyang Military General Hospital neurosurgery for epilepsy center from June 2012 to June 2014 were treated 65 cases of patients intractable status epilepticus. Inclusion criteria:status epilepticus using a sufficient amount of 2-3 state first and second line anti-epileptic drug treatment continued two hours and no hair of termination. Determined by imaging, sputum culture, hospital-acquired pneumonia as a diagnostic criterion for pulmonary infection. The first of the seizure types, causes, treatment, prognosis and other clinical features were analyzed,Then to further analyzed relevant factors intractable status epilepticus had lung infection. Whether the risk of lung infections will be divided into infection group and non-infected group,Set pulmonary infection as the dependent variable, the patient’s age, sex, smoking, hospitalization time (including emergency treatment outside the hospital and time), seizure frequency, level of consciousness, mechanical ventilation and other factors as independent variables included in the analysis. Application of two independent samples t test, mann-whitney test, pearsonX2 test univariate analysis, whether there are differences between the test group and non-lung infection lung infection group, After passing inspection included Multivariate Logistic regression analysis, Application SPSS17.0 statistical software for statistical analysis, P<0.05 considered statistically significant.Restlts:65 patients in this study,43 cases were male and 22 females, more men than women.8 patients died, the mortality rate of 12.3%. Endotracheal intubation in 24 cases, 11 cases of tracheotomy tube,40 cases of pulmonary infection, the infection rate of 62%. Seizure type, comprehensiveness convulsive status epilepticus 42 cases (65%), partial status epilepticus seizures in 21 patients (32%), non-convulsive status epilepticus two cases (3%), convulsive status epilepticus, significantly more than non-convulsive status epilepticus.4 cases of acute brain injury, chronic traumatic brain injury after 10 cases of epilepsy, brain tumors in 15 cases,3 cases of cavernous hemangioma, arterial aneurysm subarachnoid hemorrhage two cases, two cases of hypertensive intracerebral hemorrhage, hypoxic-ischemic 6 cases of cerebrovascular disease, methamphetamine, morphine poisoning one case, dextromethorphan hydrobromide poisoning one case, three cases of mitochondrial myopathy, other/unknown reason 18 cases. Univariate analysis of pulmonary infection group and non-infected group in seizure frequency (P= 0.009), the level of consciousness (P= 0.009), mechanical ventilation (P= 0.009), etc., with a significant difference was statistically significant (P<0.05). The two groups in age, gender, smoking, treatment timing, there was no statistically significant difference (P> 0.05). Multivariate Logistic regression analysis, lung infections and their seizure frequency (OR3.321,95% CI3.321-8.764), mechanical ventilation (OR2.876,95% CI1.176-7.031) was positively correlated with the level of consciousness (OR0.286,95% CI0.97-0.84) negatively correlated.Conclusion:Seizure frequency and mechanical ventilation are risk factors for lung infection. Seizure frequency is higher, the greater the tendency of pulmonary infection; the higher the proportion of endotracheal intubation or cut, the greater the tendency to lung infections. The level of consciousness was protective factors of lung infection. The higher level of consciousness, but the smaller lung infection tendency. Early control status epilepticus seizures in order to effectively prevent lung infections, with prolonged seizures, lung infection is difficult to avoid and control.