颅内血肿清除术后气管切开患者肺部感染因素研究

发布时间：2018-02-04 19:22

本文关键词： 颅内血肿清除术气管切开术肺部感染相关因素　出处：《中华医院感染学杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的探讨颅内血肿清除术后气管切开肺部感染的危险因素、预后状况及干预对策。方法选择2012年1月-2016年1月医院接诊的245例颅内血肿清除术后行气管切开术的患者,分析发生肺部感染的危险因素,并提出针对性的干预对策。结果 245例患者中有49例发生肺部感染,感染率为20.0%;肺部感染与昏迷时间、年龄、气管切开时间、吸烟史、吸痰液、侵入性操作具有相关性;其中脑挫裂伤感染发生肺部感染率最高,其次为硬膜下血肿、硬膜外血肿;共分离49株病原菌,其中革兰阴性菌占73.47%,革兰阳性菌占22.45%,真菌占4.08%。结论在颅内血肿清除术后行气管切开术引起肺部感染的原因较多,在临床上应给予相应的措施,积极控制感染,在提高预后方面具有积极意义。
[Abstract]:Objective to investigate the risk factors of tracheotomy and pulmonary infection after intracranial hematoma removal. Methods from January 2012 to January 2016, 245 patients who underwent tracheotomy after the removal of intracranial hematoma were selected and the risk factors of pulmonary infection were analyzed. Results there were 49 cases of pulmonary infection in 245 cases, and the infection rate was 20.0%. Pulmonary infection was correlated with coma time, age, tracheotomy time, smoking history, sputum aspiration and invasive operation. The infection rate of brain contusion and laceration was the highest, followed by subdural hematoma and epidural hematoma. A total of 49 strains of pathogenic bacteria were isolated, of which 73.47 were Gram-negative bacteria and 22.45% were Gram-positive bacteria. Conclusion there are many causes of pulmonary infection caused by tracheotomy after the removal of intracranial hematoma. It has positive significance in improving prognosis.
【作者单位】：温州医科大学附属第三医院神经外科;中国医科大学绍兴医院神经外科;
【基金】：浙江省医药卫生科技计划(2014EYT202)
【分类号】：R563.1;R651.1
【正文快照】： 在重型颅脑损伤中,有着较高的致残率及病死率,在临床上常行颅内血肿清除术进行治疗,为保证患者呼吸通畅,对脑供氧进行改善、减轻脑水肿等,在颅内患者清除术后常行气管切开术[1-2]。但其作为一种有创性的人工气道,并且患者多伴有意识障碍、呼吸障碍、排痰功能不佳等情况,在术后

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