重型颅脑外伤患者术后下呼吸道感染相关因素分析

发布时间：2018-03-18 17:16

  本文选题：颅脑外伤　切入点：下呼吸道感染　出处：《中华医院感染学杂志》2017年21期 　论文类型：期刊论文

【摘要】：目的探讨和分析重型颅脑外伤患者术后下呼吸道感染相关因素及病原菌分布和耐药情况。方法选取2013年1月-2015年12月医院所收治的696例重型颅脑外伤手术患者作为研究对象,并分别对重型颅脑外伤手术患者的性别、年龄、GCS评分、基础疾病、创伤性操作、预防应用抗菌药物、营养供给、住院时间等相关因素以及病原菌分布和耐药情况进行分析。结果本研究696例重型颅脑外伤手术患者中发生下呼吸道感染75例,感染率为10.78%;年龄60岁,GCS评分≤5分,有基础疾病,侵入性操作,预防应用抗菌药物,营养供给不足,住院时间14d是重型颅脑外伤患者术后下呼吸道感染的危险因素,差异均具有统计学意义(P0.05);经Logistic回归分析,GCS评分、侵入性操作以及预防应用抗菌药物是重型颅脑外伤患者术后下呼吸道感染的独立危险因素(P0.05);75例感染患者共检出病原菌92株,其中革兰阴性菌占71.74%,革兰阳性菌占18.48%,真菌占9.78%;革兰阴性菌对美洛西林、头孢曲松、环丙沙星均表现出较高的耐药性,其耐药率均50%,对亚胺培南的耐药性较低,革兰阳性菌对青霉素、阿奇霉素、头孢唑林、苯唑西林均表现出较高的耐药性,其耐药率均50%,对万古霉素耐药性较低。结论重型颅脑外伤患者术后下呼吸道感染与GCS评分,侵入性操作,预防应用抗菌药物等因素相关,病原菌分布以革兰阴性菌为主,应结合其耐药情况及时合理应用抗菌药物。
[Abstract]:Objective to investigate and analyze the related factors of lower respiratory tract infection, the distribution of pathogenic bacteria and drug resistance in patients with severe craniocerebral trauma after operation. Methods 696 patients with severe craniocerebral trauma were selected from January 2013 to December 2015. Gender, age and GCS scores, basic diseases, traumatic operations, prophylactic use of antimicrobial agents, nutrition supply were evaluated in patients with severe craniocerebral trauma. Results there were 75 cases of lower respiratory tract infection in 696 patients with severe craniocerebral trauma, the infection rate was 10.78%, and the GCS score of 60 years old was 鈮，

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