重型颅脑损伤合并肺部感染的临床研究

Clinical Analysis of Severe Traumatic Brain Injury and Respiratory Infection

目的探讨重型颅脑损伤患者合并肺部感染危险因素及病原菌特点。方法选取我院重型颅脑损伤患者1150例其中合并肺部感染390例,分析其危险因素及病原学检查结果。结果增加肺部感染的因素有年龄较大、住院时间长、使用呼吸机、气管切开、创伤前有休克、多发损伤以及合并基础疾病(P<0.05)。调查390例患者共送检痰标本320次,分离出细菌190株,其中革兰阴性菌135株,占71.0%;革兰阳性菌30株,占15.8%;真菌25株,占13.2%。合并肺部感染患者经治疗,治愈294例,死亡60例,中途放弃治疗36例。结论导致重型颅脑损伤合并肺部感染的主要因素有年龄、住院时间、气管切开、休克、基础病变等,其主要致病菌为革阴性菌,其次为革兰阳性菌、真菌,针对上述危险闪素采取有效措施可降低感染率。

Objective To investigate the risk factors and preventive measm′ement for respiratory infection in patients with severe traumatic brain injuL′y.Methods A total of 390 cases of severe traumatic brain injury with respiratury infection were analyzed and the risk factors were summarized.Results According to investigations and studies,the risk factors of hospital infection were age,length of stay,traeheost any,shock,and the underlying diseases.A total of 285 pathogens were isolated from 390 cases of respiratory infection,including gram negative bacteria,accounting for 70%.Followed by gram positive bacteria,accounting for 15.3% an d the fun gi accounting for 13.7%.There were 294 cases of recmrcry.60 death cses due to respiratory infection and 36 COSeS dropping out of the treatment.Conclusion The major risk factors of respiratory infection in severe traumatic brain injury go as follows：age,length of stay,tracheostomy,shoek,and underlying diseases.The major pathogens are gram negative bacteria,followed by gram positive bacteria and fungi.According to these risk factors,effective measurement COil be performed to reduce the hospital intetion rate.