颅脑损伤气管切开肺部感染的护理干预对策

Nursing intervention of pulmonary infection after tracheotomy among brain damage patients

目的探讨重症颅脑损伤气管切开肺部感染的相关因素与护理干预对策。方法对神经外科76例重症颅脑损伤气管切开病例进行分析,并定期对患者呼吸道分泌物进行培养,药敏试验,分析肺部感染的因素。结果气管切开并发肺部感染率高,78例中有62例发生肺部感染,感染率达79.49%。其中45例发生在气管切开后3~10 d内,有2例直接死于肺部感染。结论肺部感染是重症颅脑损伤患者常见且严重的并发症之一,故加强病房管理、湿化气道、充分吸痰、消毒隔离、准确使用抗生素等是防治肺部感染的关键,且加强气管切开术后3~10 d的护理是重中之重。

Objective To analyze the incidence of pulmonary infection after tracheotomy and nursing intervention of severe brain injury.Methods Seventy-eight patients with sever brain injury after tracheotomy were chosen and analyzed.Respiratory excrement was cultured regularly and drug sensitivity test were done to patients.The factors of pulmonary complications were analyzed as well.Results After tracheotomy,the pulmonary complications had higher incidence rate.Sixty-two out of 78 patients had pulmonary complications（79.49%）.Forty-five patients had the pulmonary complications within 3-10 days and two patients died directly of pulmonary complications.Conclusion Pulmonary complication is one of the commonest and most serious complications for patients with sever brain injury.Therefore,it is essential to strengthen ward management,wet trachea,completely suck out phlegm,enforce disinfection and separation and accurately use antibiotics in order to prevent pulmonary complications.And the nursing within 3-10 days after the tracheotomy is the most important of all.