烧伤患者医院获得性肺炎的病原学特点及危险因素分析

发布时间：2018-04-30 03:26

本文选题：烧伤 + 医院获得性肺炎　；参考：《中华医院感染学杂志》2017年11期

【摘要】：目的探究烧伤患者医院获得性肺炎(HAP)的病原学特点并对其危险因素进行分析,为临床医师在治疗和院内获得性肺炎的相关预防上提供一定的参考依据。方法选择2012年1月-2015年7月在医院收治的烧伤患者1 320例,对医院获得性肺炎的病原学特点及相关危险因素进行分析。结果痰培养结果显示,病原菌分布主要以革兰阴性菌为主119株占76.3%,革兰阳性菌24株占15.4%,真菌13株占8.3%,创面分泌物结果显示,分离病原菌175株,革兰阴性菌中主要以铜绿假单胞菌(48株占27.4%)和不动杆菌属(19株占14.7%)为主,革兰阳性菌主要以金黄色葡萄球菌(28株占16.0%)为主,真菌以白念珠菌(10株占5.7%)为主;危险因素的研究结果显示,患者年龄偏大、烧伤程度严重、合并吸入性肺炎以及侵入性操作是HAP患者感染的独立危险因素(P0.05)。结论详细了解烧伤感染患者病原学的分布,并依据病原菌的特点进行抗菌药物的选择,尽量避免胃肠道食管的反流及减少相关侵入性操作的次数,加强培养护理人员无菌观念,及时处理烧伤患者的创面,对于改善患者预后和提高治疗效果有着很大的帮助,值得临床推广。
[Abstract]:Objective to explore the etiological characteristics of hospital acquired pneumonia (HAP) in burn patients and analyze its risk factors so as to provide some references for clinicians in the treatment and prevention of hospital acquired pneumonia. Methods 1 320 burn patients admitted in hospital from January 2012 to July 2015 were selected and the etiological characteristics and related risk factors of nosocomial pneumonia were analyzed. Results the results of sputum culture showed that the distribution of pathogenic bacteria was mainly Gram-negative bacteria (76.3 strains), Gram-positive bacteria (24 strains) 15.4m, fungi (13 strains) 8.3%. The results of wound secretion showed that 175 strains of pathogenic bacteria were isolated. Among Gram-negative bacteria, 48 strains of Pseudomonas aeruginosa (27.4%) and 19 strains of Acinetobacter (14.7%), 28 strains of Gram-positive bacteria (16.0%) and 10 strains of Candida albicans (5.7B) were the main strains of Gram-negative bacteria. The results of the study on risk factors showed that the age of the patients was higher, the degree of burn was serious, the patients with inhaled pneumonia and invasive operation were the independent risk factors of HAP infection (P 0.05). Conclusion to understand the distribution of etiology in patients with burn infection in detail, and to select antimicrobial agents according to the characteristics of pathogenic bacteria, to avoid reflux of gastrointestinal esophagus and reduce the number of invasive operations, and to strengthen nursing staff's aseptic concept. The treatment of burn wounds in time is of great help to improve the prognosis and therapeutic effect of burn patients, and is worthy of clinical promotion.
【作者单位】：南阳南石医院护理部;南阳南石医院烧伤整形科一病区;南阳南石医院检验科;南阳南石医院院感办;
【分类号】：R563.1;R644

【相似文献】