摘要
目的对神经外科重症监护病房(NICU)内重型颅脑损伤患者发生肺部感染的相关危险因素及病原学分析,为防治肺部感染提供依据。方法回顾性分析NICU内收住的297例重型颅脑损伤患者的临床资料,统计院内肺部感染的发生率并分析发生的危险因素,对病原学检测结果进行分析,采取针对性防治措施。结果 NICU内重型脑损伤患者院内肺部感染59例,发生率为19.9%,肺部感染的发生受到患者年龄、昏迷程度(GCS评分)、入住时间、机械通气、气管切开、是否手术、合并基础疾病以及吸烟史的影响(P<0.05);G+菌及多重耐药菌感染呈上升趋势。结论针对重型颅脑损伤患者发生肺部感染的危险因素,并根据病原菌分布,采取严格的消毒隔离措施,规范使用抗菌药物,是降低院内感染发生率的关键。
Objective To analyze the risk factors of pulmonary infection in severe brain injury patients in Neurosurgery Intensive Care Unit （ NICU） ,and to strengthen the clinical measures to prevent pulmonary infections. Methods The clinical data of 297 serious brain injury patients hospitalized in the NICU of Taixing Hospital Affilia- ted to Yangzhou University from Jan. 2012 to Jan. 2013 were analyzed retrospectively. The clinical prevention measures were taken according to the corresponding risk factors. Results The incidence rate of nosocomial pulmo- nary infection in severe brain injury patients was 19. 9%. The pulmonary infection occurrence was correlated with patients ＇ age, the score of Glasgow Coma Scale, mechanical ventilation, tracheotomy, length of stay in NICU, com- bined underlying disease,operation treatment and smoking history （ P 〈 0. 05 ）. Gram-positive bacteria and multi- drug resistant bacteria infection were on the rise. Conclusion The advanced age,coma, mechanical ventilation, tracheotomy,long time staying in NICU, combined underlying disease, operation treatment, and smoking history are risk factors for the nosocomial pulmonary infections in patients with severe brain injury. Strict disinfection and isola- tion in NICU and appropriate preventive measures should be taken to reduce the incidence of pulmonary infection and to promote patients＇ rehabilitation.
出处
《创伤外科杂志》
2014年第1期11-13,共3页
Journal of Traumatic Surgery
