ICU颅脑损伤患者肺部感染的危险因素及预防对策

Relevant Factors and Preventive Measures of ICU Brain Injury with Pulmonary Infection

目的探讨引起ICU颅脑损伤患者肺部感染的危险因素及预防对策。方法回顾性调查分析ICU收治的189例颅脑损伤患者的临床资料,发生肺部感染的126例作为观察组,无肺部感染的63例作为对照组,采用单因素及多因素logistic回归分析其危险因素。结果肺部感染的发生率为66.7%,单因素分析发现年龄,住院≥7d基础疾病侵入性操作,使用抗酸剂使用糖皮质激素GCS计分低与并发肺部感染有关。多因素logistic回归分析发现,ICU≥7d(OR=1.981,95%CI1.009-3.891)侵入性操作(OR=4.474,95%CI1.863-10.742GCS计分低(OR=2.443,95%CI1.187-5.028)是独立危险因素。结论 ICU颅脑损伤患者肺部感染率较高,与多种因素有关,应根据危险因素采取有效措施,减少ICU颅脑损伤患者肺部感染。

Objective To explore the relevant factors and preventive measure against the brain injury in ICU with pulmonary infection. Methods The clinical date of 189 case of brain injury treated in ICU were analyzed retrospectively ,126 cases with pulmonary infection were in the observation group,and 63 cases without pulmonary infection were in the control group, at the same time univariate analysis and multivariate logistic regression were used for staststics analysis. Results The incidence of lung infection was 66.7% .Univariate analysis revealed that seven factors associated with the pulmonary infection were ICU stay time ≥7 d, invasive operation, age, underlying diseases, acid-suppressing agents and hormones ,low GCS score. Multivariate Logistic regression analysis three independent factors as ICU stay time ≥7d （OR=1.981 95%CI 1.009-3.891） invasive operation（OR=4.474 95% C1 1.863-10.742） Low GSC score （OR=2.443 95%CI 1.187-5.028）. Conclusions The pulmonary infection in ICU brain injury is higher. Due to a variety of factors.the effective strategies and measures should be carried out to reduce the pulmonary infection with brain injury in ICU.