重型颅脑损伤患者气管切开术后肺部感染原因分析及对策

发布时间：2018-04-29 16:19

  本文选题：重型颅脑损伤 + 气管切开　； 参考：《中华医院感染学杂志》2014年02期

【摘要】：目的探讨重型颅脑损伤患者气管切开术后肺部感染原因及其对策,为其治疗及预防提供依据。方法选取2010年2月-2012年9月医院行气管切开术的53例重型颅脑损伤患者为研究对象,将其中不同年龄、昏迷时间、慢性基础疾病、吸烟史及脑损伤类型者肺部感染率进行比较,分析肺部感染者的病原菌分布,同时对肺部感染患者进行针对性处理,对感染患者的预后情况进行统计分析。结果 53例重型颅脑损伤患者中发生肺部感染27例,感染率为50.94%,其中≥60岁者、昏迷时间≥1周、伴发慢性基础疾病、有吸烟史者及脑挫裂伤患者的肺部感染率分别为69.23%、72.22%、73.33%、67.86%及63.33%,明显高于其他患者,差异均有统计学意义(P0.05);27例肺部感染患者中共分离病原菌28株,其中革兰阴性菌17株占60.71%,革兰阳性菌9株占32.14%,真菌2株占7.14%。结论年龄较大、昏迷时间较长、伴发慢性基础疾病、有吸烟史及脑挫裂伤为重型颅脑损伤患者气管切开术后肺部感染的重要原因,且以革兰阴性菌感染为主,经针对性处理可有效控制感染。
[Abstract]:Objective to explore the causes and countermeasures of pulmonary infection in patients with severe craniocerebral injury after tracheotomy, and to provide evidence for its treatment and prevention. Methods from February 2010 to September 2012, 53 patients with severe craniocerebral injury underwent tracheotomy in our hospital. The lung infection rates were compared among the patients with different age, coma time, chronic basic disease, smoking history and brain injury type. The distribution of pathogenic bacteria in pulmonary infection was analyzed, and the prognosis of patients with pulmonary infection was statistically analyzed. Results Pulmonary infection occurred in 27 of 53 patients with severe craniocerebral injury, the infection rate was 50.94, and the coma time was more than 1 week for those 鈮，

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