重症颅脑损伤医院感染因素的研究

Risk Factors of Hospital Infection of Heavy Craniocerebral Injury

目的 探讨重症颅脑损伤 (GCS<8分 )并发医院感染的危险因素。方法 选取神经外科住院时间≥ 72 h,GCS<8分的 2 0 4例患者 ,互合医院感染诊断标准作为重症颅脑损伤 (HCI)感染组 ,未感染组为对照组 ,采用单因素分析与多因素分析其危险因素。结果 对 30多个可能的危险因素进行单因素分析 ,有 2 0种差异呈显著性 ;在对这 2 0多个变量进行非条件 L ogistic分析表明 ,误吸、抗生素使用种类、雾化吸入、空腹血糖升高、留置胃管为HCI感染因素。结论 HCI感染是多因素作用的结果 ,但通过加强监护 ,医院感染是可以控制和减少的。

OBJECTIVE To find out the risk factors of hospital infection of heavy craniocerebral injury (HCI). METHODS A total of 204 patients from Neurology Department and Neurosurgery Department whose duration in hospital equaled or exceeded 72 hours and who fitted in with the criterion for the diagnosis of hospital infection were chosen as the HCI infection group while HCI patients without hospital infection served as the control group. The risk factors for HCI were studied by means of both single factor analysis and multifactor analysis. RESULTS More than 30 possible risk factors were studied by means of single factor analysis, of which more than 20 showed marked difference. The results by Logistic regression analysis of more than 20 variables, indicated that misinhalation, stomach tube, antibiotics usage, spray inhalation and fasting blood-glucose increase were the risk factors of HCI infection. CONCLUSIONS HCI infection results from the synergetic action of various factors and hospital infection could be controlled and reduced by strengthening supervision.