摘要
目的探讨脑外伤患者气管切开后肺部感染的相关危险因素,并对其提出相应的护理对策,为其临床防治提供依据。方法共纳入356例入住医院神经外科的脑外伤患者,所有患者根据病情均需行气管切开,收集所有患者的基本信息及相关病史,根据其是否发生肺部感染分为感染组与未感染组,应用多因素回归分析进行多因素分析。结果 356例脑外伤患者中有120例患者发生肺部感染,感染率为33.7%;脑外伤患者发生肺部感染患者的气管切开时间、有糖尿病史、有吸烟史、留置胃管、抗菌药物的使用、激素的使用、有合并伤分别为(10.4±3.2)d、56.7%、58.3%、54.2%、58.3%、64.2%、56.7%,明显高于未感染组患者的(7.7±3.3)d、44.9%、46.6%、40.7%、44.9%、44.9%、42.8%,而GCS评分(3.2±0.9)及白蛋白水平(29.0±3.2)g/L明显低于未感染组患者的(6.8±1.3)分、(36.9±4.2)g/L,气管切开时间的延长、存在糖尿病史、吸烟史、合并伤及白蛋白水平的低下、GCS评分越低、有留置胃管、抗菌药物及激素使用的患者更容易发生肺部感染,两组间比较差异有统计学意义(P<0.05);脑外伤患者发生肺部感染的独立危险因素分析,结果表明:气管切开时间的延长、糖尿病史、GCS评分低下及使用激素是脑外伤患者发生肺部感染的独立危险因素(P<0.05)。结论脑外伤患者发生肺部感染与气管切开时间的延长、糖尿病史、GCS评分低下及使用激素存在密切的相关性,在临床工作中,对于上述危险因素进行必要的干预有重要意义。
OBJECTIVE To explore the related risk factors of the pulmonary infections in brain injury patients after tracheotomy and put forward the corresponding countermeasures so as to provide basis for the clinical prevention. METHODS The participants included 356 brain injury patients in the neurosurgery department of the hospital, all the patients underwent the tracheotomy according to the condition, the basic information and related disease history of all the patients were collected and divided into the infection group and the non-infection group according to the status of pulmonary infections, and the multivariate regression analysis was performed. RESULTS Of totally 356 cases of cerebral trauma patients, the pulmonary infections occurred in 120 patients, the infection rate was 33.7%. The tracheal dissection time of the brain injury patients with lung infections was （10.4±3.2）d, diabetes history （56.7 % ）, smoking history （58.3 % ）, indwelling gastric tube （54.2 % ）, the use of antibiotics （58.3 %）, the use of the hormone （64.2%）, and complication of injury （56.7%）, significantly higher than that of the non- infection group which were （7.7＋3.3） d, 44.9%, 46.6%, 40.7%, 44.9%, 44.9M, and 42.8% ,respectively. The GCS score （3.2±0.9） and albumin level （29.0±3.2） g/L of the infection group were obviously lower than that of the non-infection group with GCS score of （6.8±1.3） and the albumin level of （36.9±4.2） g/L. The patients with extended tracheal incision time, diabetes mellitus history, smoking history, complication of injury, and low albumin level were prone to suffer from the pulmonary infections, the difference between the two groupswas statistically significant（P〈0.05）. The result of the multivariate regression analysis indicated that the extended tracheal incision time ,diabetes history, low GCS score,and the use of hormone were the independent risk factors of the pulmonary infections in the brain injury patients （P〈0.05）. CONCLUSION The pulmonary infections in the brain injury patients are closely related to the extended tracheal incision time,diabetes history, low GCS score and the use of hormone. It is of great significance to carry out the necessary interventions to the risk factors.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第9期2099-2101,共3页
Chinese Journal of Nosocomiology
关键词
脑外伤
气管切开
肺部感染
多因素分析
Brain injury
Tracheotomy
Pulmonary infection
Multivariate analysis
作者简介
李东峰，E-mail：grlidongfeng@163．com
