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Objective To construct a risk prediction model for pulmonary infection in stroke patients and verify its clinical predictive performance. Methods Using convenience sampling, 750 stroke patients hospitalized in a tertiary hospital in Guizhou Province from January 2021 to January 2023 were selected as study subjects. They were divided into a pulmonary infection group (n=267) and a non-pulmonary infection group (n=483) based on whether pulmonary infection occurred. Comparative analysis of relevant data between the two groups was conducted. Logistic regression analysis was applied to establish a risk prediction model. The goodness-of-fit of the model was tested using the Hosmer-Lemeshow (H-L) test, and the predictive performance of the model was evaluated by the area under the receiver operating characteristic curve (ROC curve). Another 145 eligible patients from February to August 2023 were selected to validate the predictive performance of the model. Results Univariate and multivariate analyses revealed that dysphagia [odds ratio (OR) =10.462], coexisting pulmonary diseases (OR=6.046), hypokalemia (OR=2.266), hyponatremia (OR=3.807), low hemoglobin (OR=4.036), National Institutes of Health Stroke Scale (NIHSS) score at admission (OR=38.135), Activities of Daily Living (ADL) score at admission (OR=12. 942), and length of hospital stay (OR=8.992) were independent risk factors for pulmonary infection in stroke patients (P＜0.05). The risk prediction model formula was: Logit (P) =-4.761+2. 348× (dysphagia score) +1.799× (coexisting pulmonary diseases score) +0.818× (hypokalemia score) +1. 337× (hyponatremia score) +1.395× (low hemoglobin score) +3. 641× (NIHSS score) +2.560× (ADL score) +2.196× (length of hospital stay score). The area under the ROC curve of the modeling group was 0.953 [95% confidence interval (95%CI) 0.940-0. 967, P＜0.001], with a Youden index of 0.762, a sensitivity of 0.880, a specificity of 0. 882, and a P value of 0. 553 in the H-L test. The validation results showed that the area under the ROC curve of the validation group was 0. 946 (95%CI: 0. 927-0. 987, P＜0.001), with a sensitivity of 0. 898, a specificity of 0. 875, an accuracy of 88. 3%, and a P value of 0. 510 in the H-L test. Conclusion The established risk prediction model for pulmonary infection in stroke patients has good predictive performance, providing a reference for clinical healthcare professionals to early identify high-risk groups for stroke induced pulmonary infection and facilitating the timely adoption of preventive management measures. [ABSTRACT FROM AUTHOR]

Objective To investigate the factors influencing the development of severe pneumonia in patients with human immunodeficiency virus (HIV )/acquired immunodeficiency syndrome (AIDS). Methods This study retrospectively analyzed the clinical data of 139 patients with HIV/AIDS combined with pulmonary infections admitted to the Department of Infectious Diseases of General Hospital of Ningxia Medical University from January 2017 to August 2023, among which 48 cases were in the severe pneumonia group and 91 cases were in the non-severe pneumonia group. The influencing factors on the occurrence of severe pneumonia in patients with HIV/AIDS were analyzed by using logistic regression, and the predictive value of the indicators for severe pneumonia was analyzed by plotting the work characteristics of the subjects (ROC) curves. Results The incidence of severe pneumonia was 34. 5% (48/139) in 139 patients with HIV/AIDS coinfection of the lungs. Univariate analysis showed that cough, shortness of breath, percentage of neutrophils, percentage of lymphocytes, absolute value of lymphocytes, prothrombin activity (PTA), CD4+T and CD8+T lymphocyte counts, neutrophil/lymphocyte ratio (NLR), albumin, number of pathogens greater than or equal to two, and continuous strong antiretroviral therapy (ART) treatment (>three months) were significantly associated with severe pneumonia in HIV/AIDS patients (P <0. 05). Logistic stepwise regression analysis showed that previous pneumocystis pneumonia (PCP), number of pathogens greater than or equal to two, elevated NLR, elevated PTA, and shortness of breath were independent risk factors for severe pneumonia in HIV/AIDS patients, continuous ART treatment (>three months) and CD8+ T cell count were independent protective factors (P <0. 05). The area under the curve of multi-factor combined prediction is the largest (AUC=0. 917, 95%CI 0. 873-0. 961, P <0. 01). Conclusion The occurrence of severe pneumonia in HIV/ AIDS patients is closely related to previous PCP, number of pathogens greater than or equal to two, high NLR, high PTA, shortness of breath, continuous ART treatment (>three months), CD8+T cell count. Multifactor combined prediction have good predictive value [ABSTRACT FROM AUTHOR]

Objective To systematically evaluate the diagnostic value of metagenomic next-generation sequencing(mNGS) for detecting pulmonary infection. Methods PubMed, Embase, Web of Science, the Cochrane Library, CNKI, WanFang, VIP databases were searched for studies according to the criteria of inclusion and exclusion, enrolling literature recorded from database establishment to May 30,2022. Statistical analysis was performed by Meta-Discl. 4, RevMan5. 3 and STATA15.0 software. Results A total of 12 relevant studies were enrolled, including 1 154 patients. The results of meta-analysis showed that the pooled sensitivity was 0.82(95% CI 0.79-0.84, 189.1%), and the pooled specificity was 0.73 (95% CI 0.68 0.78, I² = 85.4%). The heterogeneity in sensitivity and specificity between studies was significant. The area under the curve (AUC) of the total subject operating characteristic curve (SROC) was 0.850, and the Q index was 0. 782. Conclusion The diagnostic performance of mNGS in the clinical application of lung infections is acceptable. [ABSTRACT FROM AUTHOR]

Objective To systematically review effects of different anesthesia methods on pulmonary in- fection after hip replacement. Methods The databases such as PubMed, CochrianeLibriariy, Web of Science, EMbase, CNKI, VIP and Wanfang were retrieved, and the randomized controlled trials on the effects of in- traspinal anesthesia and general anesthesia on pulmonary infection after hip replacement were collected. Ac- cording to the anesthesia method, intraspinal anesthesia was included in the observation group, general anes- thesia was included in the control group, and the observation group was further divided into the lumbar/epi- dural anesthesia subgroup, the lumbar hard combined anesthesia subgroup, the 50-65 years old subgroup.and the >65 years old subgroup. Meta analysis was performed by using RevMan 5. 3 software. Results A total of 14 articles were included, involving 1 478 patients. Meta analysis showed that the incidence of postoperative pulmonary infection in the observation group was lower than that in the control group, with statistically sig- nificant difference (P<0.001). The incidence of postoperative pulmonary infection in the lumbar/epidural an- esthesia subgroup and the lumbar hard combined anesthesia subgroup were lower than that in the control group, and the difference were statistically significant (P<0.05). There was no statistically significant differ- ence in the incidence of postoperative pulmonary infection between the lumbar/epidural anesthesia subgroup and the lumbar hard combined anesthesia subgroup (P>0.05). The incidence of postoperative pulmonary infection in the 50-65 years old subgroup and the >65 years old subgroup was lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion Intraspinal anesthesia is superior to general anesthesia, which can reduce the incidence of pulmonary infection after hip replacement. [ABSTRACT FROM AUTHOR]

Objective To search the best evidence about the prevention and nursing of pulmonary infection in patients with ischemic stroke at home and abroad, and evaluate and summarize the evidence, so as to provide scientific reference for clinical nurses to evaluate the prevention and nursing plan. Methods According to the principle of 6S [SEIRI (sorting out), SEITON (rectifying), SEISO (cleaning), SEIKETSU (sweeping), SHITSUKE (literacy) and SAFETY (safety)], the domestic and foreign literatures were systematically searched. The types of literatures searched were the best evidence, guidelines, expert consensus, clinical practice and systematic evaluation, and the retrieval time was from the establishment of the database to May 2022. Literature screening, quality evaluation and evidence extraction were conducted by two professional researchers. Results A total of 12 articles were included, including 2 guidelines, 5 systematic reviews, 1 expert consensus, 3 evidence summaries and 1 clinical decision. The summarized evidence includes 30 recommendations from eight aspects: risk factor assessment, early identification and prevention, medication care, diet care, strengthening respiratory care, posture adjustment, strengthening functional exercise and oral care. Conclusion The prevention and nursing of ischemic stroke complicated with pulmonary infection has certain practical reference significance, which is helpful to improve the quality of clinical nursing. [ABSTRACT FROM AUTHOR]

上消化道肿瘤是以食管癌、胃癌为主,目前以手术为首选治疗的癌症。肺部感染是肿瘤根治术 后常见的并发症,在延长住院时间、增加经济负担的同时,甚至有发展成呼吸衰竭致死的可能。国内外研究报 道,肺部感染的危险因素包括高龄、吸烟、合并肺部疾病、合并糖尿病、营养状况差、麻醉方式、手术方式、手术时 长、引流管放置、术后疼痛等,并提出多种干预措施,以减少其发生。该文对上消化道肿瘤术后并发肺部感染的 危险因素及干预措施予以综述。 [ABSTRACT FROM AUTHOR]

目的 探讨银黄清肺胶囊辅助治疗尘肺病合并肺部感染痰热壅肺证的临床效果。方法 选取 2020年9月至2021年7月湖南省中医药研究院附属医院肺病科收治的60例尘肺病合并肺部感染痰热壅肺证 患者作为研究对象,采用随机数字表法将其分为治疗组和对照组,各30例。对照组采用左氧氟沙星抗感染、氨 茶碱解痉平喘、溴己新化痰及吸氧等常规处理,治疗组在对照组的基础上加用银黄清肺胶囊,疗程为10d。比 较两组患者的疗效、治疗前后中医症候积分、炎症因子水平和动脉血氧饱和度(SaO2)的变化情况。结果 治疗 组患者的总有效率高于对照组,差异有统计学意义(P<0.05)。两组患者治疗后的中医症候积分均较治疗前明 显降低,且治疗组治疗后的中医症候积分均低于对照组,差异均有统计学意义(P<0.05)。两组患者治疗后的 C-反应蛋白(CRP)及降钙素原(PCT)水平均明显低于治疗前,且治疗组治疗后 CRP及 PCT 水平均明显低于对 照组,差异均有统计学意义(P<0.05)。治疗后,两组患者 SaO2 水平较治疗前均升高,且治疗组高于对照组, 差异均有统计学意义(P<0.05)。结论 尘肺病合并肺部感染痰热壅肺证患者在常规西医治疗基础上加用银 黄清肺胶囊治疗,可有效改善患者症状,降低感染指标,提高SaO2,疗效满意,值得临床应用. [ABSTRACT FROM AUTHOR]

Objective To systematically evaluate the risk factors of postoperative pulmonary infection in patients with esophageal cancer. Methods The databases of SinoMed, PubMed, EMBASE, Web of Science, the Cochrane Library, CINAHL, CBM, CNKI, Wanfang and VIP were searched by computer. The literature on postoperative pulmonary infection in patients with esophageal cancer published from the establishment of the database to June 2021was collected. The meta-analysis was performed by using RevMan5. 3and Stata16. 0software. Results A total of 19literatures involving 6 529patients were included. Age greater than or equal to60years old, smoking history, diabetes, chronic obstructive pulmonary disease, coronary heart disease, hypoproteinemia, tumor located in the upper middle part, operation time greater than or equal to 4h, open chest surgery, one lung ventilation, intraoperative blood loss greater than 800mL, postoperative no use of auto-controlled epidural analgesia, use time of acid inhibitor, and recurrent laryngeal nerve injury were risk factors for postoperative pulmonary infection in patients with esophageal cancer (P<0. 05) . Conclusion There are many risk factors of postoperative pulmonary infection in patients with esophageal cancer. Medical staff should pay attention to relevant risk factors, early prevention and early intervention, so as to reduce the incidence of pulmonary infection and improve the quality of life and prognosis of patients. [ABSTRACT FROM AUTHOR]

目的 研究综合护理在神经外科重症监护室 (NICU) 患者预防肺部感染中的应用效果。 方法 采用回顾性分析方法。选取2020年1—12月该院神经外科收治入住 NICU 的患者 156 例作为对照组, 另将 2021 年1—10月该院神经外科收治入住NICU 的患者131例作为观察组。对照组采用常规护理进行干 预, 观察组采用综合护理进行干预, 统计2组患者肺部感染发生率、平均抗菌药物应用时间、住院时间、住院费 用等。结果 观察组患者肺部感染率为 6.10% (8/131), 明显低于对照组的13.46% (21/156), 差异有统计学 意义(P <0.05)。观察组患者平均抗菌药物应用时间明显短于对照组, 差异有统计学意义(P <0.05)。 结论 综合护理措施能够提高神经外科重症患者的护理质量, 减少抗菌药物的应用时间, 有效预防肺部感染及 并发症的发生, 促进患者康复。 [ABSTRACT FROM AUTHOR]

总结1例老年糖尿病并发肺部感染合并胸腔积液的护理经验。护理要点包括:全面评估患者 的营养状况,根据老年人的代谢特点,加强对症及营养支持治疗、血糖控制、抗感染护理、肠内外营养护理、胸腔 引流护理、下肢静脉血栓的护理。经过多学科综合治疗及对精心舒适的护理照顾,该患者血糖控制较好,感染、 胸腔积液好转,营养状况较前明显改善,预后较好,最终康复出院。 [ABSTRACT FROM AUTHOR]

目的探讨术前雾化吸入对脊柱手术患者术后肺部感染的预防效果。方法选取2019 年1 月至2020 年1 月该院收治的脊柱手术(开放性手术,麻醉方式均为气管插管全身麻醉)患者120例,随机将其分 为对照组与观察组,每组60例。对照组实施常规处理,观察组实施术前给予(布地奈德和异丙托溴铵)雾化吸 入。观察2组患者术后出现肺部感染情况。结果观察组患者术后当天痰液黏稠度､术后肺部感染发生率均 低于对照组,差异均有统计学意义(P<0.05)。结论脊柱手术患者术前给予雾化吸入不仅能降低患者术后爽 液黏稠度,使痰更容易咳出,而且能有效降低术后肺部感染发生率,改善患者预后. [ABSTRACT FROM AUTHOR]

目的探讨爬坡式床上运动预防老年患者开腹手术后肺部感染效果。方法选取2018年1月至2019年12月该院普外科接受开腹手术的130例老年患者作为研究对象,随机分为干预组和对照组,各65例。干预组利用腹部手术后常规取半坐卧位引起身体往下滑的特点,设置床头10°~20°,设定动作,指导患者依靠自身力量向床头移动,刺激呼吸肌收缩,产生深呼吸;对照组则在照护者的帮助下取舒适体位,观察两组术后3d的排痰情况及术后肺部感染发生率。结果干预组患者术后第1、2、3天的无效排痰例数和术后肺部感染发生率均低于对照组,差异均有统计学意义(P<0.05)。结论爬坡式床上运动能促进老年患者开腹手术后及时有效排痰,降低肺部感染发生率。 [ABSTRACT FROM AUTHOR]

目的探讨早期急性脑梗死患者并发肺部感染的高危因素，评估系统化护理对急性脑梗死并发肺部 感染患者的影响。方法选取该院2016 年9 月至2017 年11 月住院治疗的急性脑梗死患者共120 例，按随机数字表 法分为对照组和干预组，各60 例。对照组患者给予神经内科常规护理，干预组评估患者存在的个体高危因素，制定系 统化护理措施提供早期优质护理干预。比较2 组患者并发肺部感染率、急性脑梗死病死率及因并发肺部感染导致的死 亡率。结果通过早期评估、实施系统化护理，干预组并发肺部感染率、病死率均明显低于对照组，差异均有统计学意 义（P<0.05）。干预组的感染死亡率为0.00%，对照组为22.0%，但2 组比较，差异无统计学意义（P>0.05）。结论早期评 估、系统化护理干预，能有效控制急性脑梗死肺部感染并发症，降低感染率，提高急性脑梗死治愈率，降低病死率。 [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical value of mean lymphocyte count ( ALY) in the short term prognosis of patients with systemic lupus erythematosus ( SLE) complicated with pulmonary infection. Methods Forty six patients with SLE and pulmonary infection who were hospitalized from January 2013 to December 2017 were enrolled as subjects (infected group). Forty six patients with uninfected SLE were selected as the control group. The receiver operating curve ( ROC curve) was used to evaluate the value of lymphocyte (LY) and ALY in the short term prognosis (30 d) of patients with SLE complicated with pulmonary infection within 24 h after admission. Results The levels of LY, T cells and CD4+ T cells in the peripheral blood of the infected group were significantly lower than those in the non infected group (P< 0. 05). Forty six patients in the infected group died within 9 days within 30 days. The LY and ALY levels in the death group were significantly lower than those in the survival group, and the difference was statistically significant (P<0.05). The area under the ROC curve for prognosis of LY and ALY was 0.763 ± 0.074 and 0.895 ± 0.054,respectively. The optimal cutoff value of ALY was 0.59 X 109 L-1. Conclusion Lymphocytes, T cells, and CD4+T cells are significantly decreased in patients with SLE complicated with pulmonary infection. [ABSTRACT FROM AUTHOR]

目的通过分析成人心脏瓣膜病患者体外循环瓣膜置换术后出现肺部感染与体外循环时间、手术时间 的相关性，从而提出预防和减少由此所致肺部感染的相关措施。方法对该院心血管外科2015 年2 月至2018 年5 月 的448 例体外循环下行瓣膜置换手术的成人心脏瓣膜病患者术后出现肺部感染情况进行回顾性分析。结果448 例患 者中，69 例术后出现肺部感染，感染率为15.40%，其中肺部感染发生率与体外循环时间呈正相关（P<0.05），而与手术时 间无显著相关性（P>0.05）。结论体外循环时间是术后肺部感染独立危险因素，缩短体外循环时间可有助于减少术后 肺部感染风险。 [ABSTRACT FROM AUTHOR]

目的探讨脊柱结核住院患者肺部感染的病原菌构成和耐药性。方法选取2008 年1 月至2017 年 12 月该院收治的626 例脊柱结核患者，采集痰液、肺泡灌洗液等标本，采用美国BD 公司phoenix100 型全自动细菌鉴 定/药敏系统进行菌株鉴定和药敏试验。结果626 例脊柱结核患者中合并肺部感染者64 例，感染率为10.22%。64 例 脊柱结核合并肺部感染患者共检出85 株病原菌，其中革兰阴性菌54 株（63.53%），革兰阳性菌18 株（21.18%），真菌13 株（15.29%）。肺炎克雷伯菌（22 株，25.88%）和鲍氏不动杆菌（14 株，16.47%）是主要革兰阴性菌。肺炎链球菌（9 株， 10.59%）是主要革兰阳性菌。肺炎克雷伯菌和鲍氏不动杆菌对亚胺培南、美罗培南和氨曲南的耐药率分别为0.00% 和 0.00%、0.00% 和7.14%、0.00% 和7.14%。肺炎链球菌对利红霉素、万古霉素、替考拉林的耐药率分别为11.11%、0.00% 和11.11%。结论革兰阴性菌是导致脊柱结核合并肺部感染的主要病原菌，且对临床常用抗菌药物青霉素类和头孢 类耐药率较高，故应及时行痰培养和药敏试验，根据试验结果合理选择抗菌药物进行治疗。 [ABSTRACT FROM AUTHOR]

目的探讨心脏外科重症监护患者肺部感染原因及其护理干预手段。方法选取2014年1月至2016 年12月该院诊治的心脏外科重症监护患者200例，将其随机分为对照组和观察组，各100例。分别对其进行常规护理干 预和针对性护理干预，分析比较两组患者的肺部感染率、误吸情况、护理质量得分及满意度情况。结果观察组患者肺 部感染率和误吸率均明显低于对照组，健康教育、病房环境、基础护理、危重护理及护理文书书写得分及患者满意度 [97.0%（97/100）]明显高于对照组[82.0%（82/100）]，差异均有统计学意义（P<0.05）。结论心脏外科重症监护肺部感染 因素较多，专业的护理干预能够明显降低患者的感染率和误吸率，提高护理质量得分，提升患者对护理的满意度，具有 重要的临床价值。 [ABSTRACT FROM AUTHOR]

目的 为了提高重症肺部感染者治疗效果并减少各种不良事件发生率,探讨选择常规抗感染联合纤维支气管镜 吸痰方案治疗的价值。方法 在佛山市禅城区永安医院2019年1月至2020年1月治疗的重症肺部感染者中抽取82例作为研 究对象,并通过随机信封法将其分为对照组(采用常规抗感染)和观察组(采用常规抗感染联合纤维支气管镜吸痰),各41例。比 较2组治疗后总有效率、动脉氧分压(PaO2)、一秒用力呼气容积百分比(FEV1%)、C反应蛋白(CRP)、降钙素原(PCT)等指标变 化。结果 观察组治疗后总有效率高于对照组,差异有统计学意义(χ2=9.52,P<0.05)。2组患者治疗前 PaO2、FEV1%水平比 较,差异无统计学意义(P>0.05);2组治疗后 PaO2、FEV1%水平较治疗前均明显提高,差异均有统计学意义(P<0.05)。2组患 者治疗后 CRP、PCT水平较治疗前均明显降低,差异均有统计学意义(P<0.05),且观察组降低幅度与对照组比较更显著,差异 有统计学意义(P<0.05)。结论 重症肺部感染患者应用常规抗感染联合维支气管镜吸痰方案治疗,在降低机体炎症水平同时 增加肺通气功能,疗效显著。 [ABSTRACT FROM AUTHOR]

该文通过对1例皮疽诺卡菌引起肺部感染病例的诊治经过的回顾性分析并文献复习,明确微生物实验室对诺卡 菌病的常规检测思路,加强临床医生对诺卡菌病的临床表现和影像学及实验室检测结果的认知,并提供常见的经验治疗药物选 择,希望对临床诊治诺卡菌病提供一定的帮助。通过此病例还提示临床医生开具痰培养医嘱同时送检痰涂片对检出诺卡菌的重 要性,同时强调微生物实验室在诺卡菌等少见菌的检测过程中需要加强与临床医生的沟通交流,且应根据需要建立相应的药敏检 测方法。 [ABSTRACT FROM AUTHOR]

目的探讨应用集束化护理方案对神经外科气管切开患者肺部感染预防的临床效果。方法选取 2015 年1 月至2016 年12 月该院神经外科收治的100 例颅脑损伤需行气管切开术患者，根据随机原则将其分为对照 组和观察组，每组50 例。对照组患者实施该院神经外科常规的基础方案护理，观察组患者应用集束化护理方案进行护 理干预。观察、比较2 组患者护理干预后肺部感染及并发症发生情况，患者气管切开时间、入住重症监护病房（ICU）时 间及住院总费用等，以及患者和家属对临床护理的满意度。结果观察组患者肺部感染发生率及并发症发生率均明显 低于对照组，患者气管切开时间、入住ICU 时间及住院总费用均明显优于对照组，患者及家属对临床护理的总满意度 明显高于对照组，差异均有统计学意义（P<0.05）。结论对神经外科气管切开患者应用集束化护理方案进行护理干 预，能有效降低患者肺部感染发生率及并发症发生率，缩短患者气管切开时间、入住ICU 时间，明显降低患者住院治疗 总费用，提高患者及家属对临床护理的满意度，其临床应用的综合效果显著，值得进一步推广使用。 [ABSTRACT FROM AUTHOR]