颅脑创伤患者术后继发肺部感染临床分析

Secondary Lung Infection in Patients of Postoperative Cranio-cerebral Trauma: A Clinical Study

目的 探讨颅脑创伤患者术后继发肺部感染危险因素及控制措施。方法 对2002年1月～2004年12月，我院收治的718例颅脑手术患者的医院感染进行前瞻性和回顾性调查分析。结果 在718例颅脑创伤患者中，发生肺部感染39例，感染率5．43％；经过治疗，肺部感染治愈27例（69．23％）；显效6例（15．3％）；好转3例（7.7％）；死亡3例（7．7%）。结论 颅脑创伤术后，氧气吸人、鼻饲、吸痰、气管插管、气管切开、使用呼吸机是引起肺部感染的危险因素，合理应用抗生素等治疗措施，可以有效地控制肺部感染的发生和发展。

OBJECTIVE To probe the risk factors of the secondary lung infection in patients of postoperative craniocerebral trauma as well as the ways to control them. METHODS A prospective and review study was carried out in 718 cases with cranio-cerebral trauma admitted in our hospital for operation from Jan 2002 to Dec 2004. RESULTS Among 718 eases, 39 （5.43%） developed lung infection, occupied 65% of the total number of the hospital infection in the neurosurgery. After an integrated （total and systemic） treatment, the cure rate was 69.23% （27 cases）; effective： 15. 3% （6）; improved; 7. 7%（3）; died; 7. 7%（3）. CONCLUSIONS Oxygen inhalation, nasal feeding, sputum drawing out, cannular tracheotomy, and use of respirator after operation are the causes of the lung infection and it can be controlled effectively if keeping the surroundings clean, keeping strict ness in disinfection-isolation institution, improving the mangement of respiratory tract and the care of oral cavity, proper use of antibiotics, and improving immunity.