神经外科113例下呼吸道感染调查分析与护理干预

Risk factors and nursing interventions for lower respiratory infections in 113 patients in neurosurgery department

目的探讨神经外科下呼吸道感染的相关因素及护理干预措施,以降低感染发生率。方法采用前瞻性和回顾性方法,对神经外科2008年1月-2010年12月发生下呼吸道感染113例患者的临床资料进行调查,并对感染危险因素进行统计分析。结果 113例并发下呼吸道感染的患者中,共发生感染141例次;病原菌检出116株,革兰阴性菌90株占77.59%,革兰阳性菌21株占18.10%,真菌5株占4.31%;危险因素除年龄较大、住院时间长外,主要为手术、气管切开/插管、昏迷和留置胃管。结论神经外科患者下呼吸道感染率高、死亡率高,应针对相关危险因素,重点预防控制,采取相应的护理干预,以减少下呼吸道感染的发生。

OBJECTIVE To discuss the related risk factors and nursing interventions for the lower respiratory infections in the neurosurgery department so as to reduce the incidence of infections.METHODS Form Jan 2008 to Dec 2010,totally 113 cases of hospitalized patients with lower respiratory infections in neurosurgery department were investigated through the retrospective and prospective methods,and the statistical analysis of the risk factors was performed.RESULTS Of 113 patients complicated by the lower respiratory tract infections,there were totally 141 case-times of patients with infections.Totally 116 strains of pathogens were detected,among which there were 90（77.59%） strains of gram-negative bacteria,21（18.10%） strains of gram-positive bacteria,and 5（18.10%） strains of fungi.Beside elder age and long length of stay,the risk factors included the operation,tracheotomy,coma and gastric tube indwelling.CONCLUSION The incidence rate of the lower respiratory tract infections is high in the neurosurgery department,and so is the mortality.It is necessary to pay attention to the risk factors and take the corresponding nursing interventions so as to reduce the incidence of the lower respiratory tract infections.