神经外科手术后医院获得性肺炎高危因素分析

Analysis on risk factors for hospital acquired pneumonia after neurosurgical operation

目的探讨神经外科手术患者医院获得性肺炎的危险因素、病原菌构成及其控制措施。方法对某院2004年5月—2006年5月收治的736例神经外科手术患者的医院获得性肺炎发生情况、相关因素及细菌培养结果进行回顾性调查分析。结果颅脑手术后医院获得性肺炎的发病率为6.11%(45/736);年龄、住院时间、意识障碍、气管切开/机械通气、抗菌药物的长期联用等是其重要危险因素;病原菌培养以革兰阴性菌为主(72.83%),其次为革兰阳性菌(19.57%),真菌(7.61%)。结论针对危险因素采取有效控制措施,并根据细菌培养和药敏结果合理选用抗菌药物是控制医院获得性肺炎的关键。

Objective To evaluate the risk factors, constitution of pathogens and control measures of hospital acquired pneumonia （HAP） in patients with neurosurgical operation. Methods A retrospective study was carried out to seek the related risk factors and to analyze the results of sputum culture in 736 neurosurgical patients hospitalized from May 2004 to May 2006. Results The HAP rate in all neurosurgical cases was 6.11 % （45/736）. The important risk factors related to HAP were age, hospitalization days, disturbance of consciousness, tracheotomy, mechanical ventilation and inappropriate use of antimicrobial agents. Gram-negative bacteria were the major pathogens （72. 83%）, the next were grampositive bacteria（19. 57%） and fungi（7. 61 %）, Conclusion According to different risk factors to carry out effective measures and proper use of sensitive antimicrobial agents based on antimicrobial susceptibility test results can decrease HAP rate.