大面积烧伤患者肺部医院感染相关因素分析

Nosocomial Pulmonary Infection in Extensively Burned Patients and Its Related Factor Analysis

目的探讨大面积烧伤并发肺部医院感染的相关因素,以便采取有效控制措施。方法回顾性分析1997年1月-2004年10月医院烧伤科收治的大面积烧伤患者193例临床病例资料。结果193例大面积烧伤患者,37例发生肺部医院感染,感染发生率19.17%,共检出致病菌248株,其中革兰阴性菌占57.66%,革兰阳性菌占40.73%,真菌占1.61%;老龄、病程、休克期复苏、烧伤面积、呼吸道吸入性损伤、气管切开及长期应用抗菌药物等与肺部医院感染密切相关;193例大面积烧伤中病死率11.40%,发生肺部医院感染者病死率27.03%,未发生肺部医院感染者病死率7.69%(P<0.01)。结论大面积烧伤肺部医院感染发生率高,应充分重视感染相关因素,进行积极有效的防治措施,减少肺部医院感染的发生。

OBJECTIVE To explore and control the related factors of nosocomial pulmonary infection in patients with extensive burn. METHODS To study retrospectively 193 hospitalized patients with extensive burn in our hospital from Jan 1997 to Oct 2004. RESULTS In 193 cases of extensive burn, there were 37 cases complicated by infection, the rate of nosocomial pulmonary infection was 19.17%. A total of 248 pathogen strains were isolated by bacterial culturing. Nosocomial pulmonary infection was closely related with such factors as aging, course of disease, burn area, burn shock with fluid resuscitation, inhalation injury, tracheotomy, antibiotic use for a long time, and so on. The mortality of 193 patients with extensive burn was 11.40%, in the infective group it was 27.03% and in the non-infective group it was 7.69% （P〈0.01）. CONCLUSIONS Nosocomial pulmonary infection is still a high frequent complication in extensively burned patients and those above mentioned related factors be paid attention. It is the most important step for the rehabilitation of extensive burn in order to effectively control nosocomial pulmonary infection.