目的: 分析脊柱损伤合并截瘫患者肺部感染发生情况及易感因素。方法: 回顾性分析2023年1月—2024年12月本院106例脊柱损伤合并截瘫患者的临床资料,依据患者是否发生肺部感染分为肺部感染组（n=42）和非肺部感染组（n=64）,采用单因素和多因素Logistic回归分析脊柱损伤合并截瘫患者肺部感染的危险因素,采用ROC曲线评估其预测价值。结果: Logistic回归结果显示年龄增长（OR=1.103,95%CI：1.031~1.181）、高位截瘫（OR=7.288,95%CI：1.246~42.643）、MNA-SF评分（OR=0.650,95%CI：0.489~0.862）和有机械通气（OR=3.997,95%CI：1.356~11.778）是脊柱损伤合并截瘫患者发生肺部感染的独立危险因素;ROC分析显示,年龄、截瘫部位、MNA-SF评分和机械通气联合预测脊柱损伤合并截瘫患者发生肺部感染的AUC值为0.870,约登指数为0.653,显著高于年龄、截瘫部位、MNA-SF评分和机械通气单独预测（Z=4.002、4.088、3.538、4.116）。结论: 脊柱损伤合并截瘫患者肺部感染发生率处于较高水平。高龄、高位截瘫、MNA-SF评分低和采用有机械通气是脊柱损伤合并截瘫患者发生肺部感染的易感因素。
Abstract
Objective To analyze the incidence and susceptibility factors of pulmonary infection in patients with spinal injury and paraplegia. Methods The clinical data of 106 patients with spinal injury and paraplegia admitted to the hospital from January 2023 to December 2024 were retrospectively analyzed. Patients enrolled were divided into the pulmonary infection group (n=42) and the non-pulmonary infection group (n=64) according to whether they had developed pulmonary infection. Univariate and multivariate logistic regression analyses were used to screen the risk factors for pulmonary infection in patients with spinal injury and paraplegia. ROC curve was used to evaluate the predictive value. Results Logistic regression analysis results showed that age (OR=1.103, 95%CI: 1.031-1.181), high paraplegia (OR=7.288, 95%CI: 1.246-42.643), MNA-SF score (OR=0.650, 95%CI: 0.489-0.862), and mechanical ventilation (OR=3.997, 95%CI: 1.356-11.778) were independent risk factors for pulmonary infection in patients with spinal injury and paraplegia. ROC analysis showed that the AUC value of combined prediction with the four factors was 0.870 and Youden index was 0.653. The values were significantly higher than those of separate prediction with each factor (Z=4.002, 4.088, 3.538, 4.116). Conclusion The incidence of pulmonary infection is relatively high in patients with spinal injury and paraplegia. Advanced age, high paraplegia, low MNA-SF score, and mechanical ventilation are susceptible factors for pulmonary infection in patients with spinal injury and paraplegia.
关键词
脊柱损伤 /
截瘫 /
肺部感染 /
发生率 /
危险因素
Key words
spinal injury /
paraplegia /
pulmonary infection /
incidence /
risk factor
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基金
上海市健康科普人才能力提升专项（青年英才）项目“基于院前急救全程信息化背景的损伤控制管理对急诊创伤性骨折患者疼痛程度及并发症的影响”（JKKPYC-2023-A13）
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