ICU重度颅脑损伤患者肺部感染临床特征分析

Clinical analysis of pulmonary infection for ICU patients with severe brain injury

[目的]探讨ICU重度颅脑损伤患者并发肺部感染的危险因素.[方法]对53例重度颅脑损伤并发肺部感染患者的临床资料进行回顾性分析.[结果]同期共收治165例重度颅脑损伤患者,其中53例合并肺部感染,感染率为32.1%.经单因素分析发现,气管切开史、住院天数≥20 d、基础疾病史、休克史和呼吸机应用史是ICU重度颅脑损伤并发肺部感染的危险因素.主要致病菌以革兰阴性杆菌为主,占72.7%,其次是革兰阳性球菌,占22.7%,真菌占4.6%.[结论]ICU重度颅脑损伤并发肺部感染与多种临床因素密切相关,其预后差,病死率高.

[Objective]To investigate the risk factors of pulmonary infection for intensive care unit （ICU） patients with severe brain injury. [Methods]To take a retrospective analysis on the clinical data of 53 patients of pulmonary infection. [Results]165 cases of severe head injury patients were treated in the same period, among them ,53 patients got pulmonary infection, the infection rate was 32.1%. Univariate analysis showed that tracheotomy, length of hospital stay ≥ 20d, history of basic diseases, shock and the application of ventilator were the risk factors of pulmonary infection for ICU patients with severe brain injury. The main pathogenic bacterium was Gram negative bacillus （72.7%）, followed by Gram-positive cocci（22.7%） and fungus （4.6%）. [Conclusion]The incidence of ICU severe head injury with pulmonary infection is closely related to variety of clinical factors with a poor prognosis and a high fatality rate.