重型颅脑损伤并发肺部感染153例分析

目的 探讨重型颅脑损伤并发肺部感染的临床规律。方法 对我科1997年3月至1999年10月收治的重型颅脑损伤并发肺部感染153例作回顾性总结。结果 感染率为67.42 % ,感染细菌19种 ,其中 :G-占81.43% ,G+ 占18.57 % ,肺炎克雷伯氏杆菌(21.81 % ) ,大肠埃希氏菌 (18.13 % ) ,绿脓杆菌 (12.94 % ) ,醋酸钙不动杆菌(12.64 %)。治疗总有效率84.31% ,无效率16.99%。感染直接致死率17.64 %。结论 肺部感染是严重的二次脑损伤因素 ;发病率高 ;发病机理复杂 ;感染菌种繁杂 ;治疗应根据药敏选择敏感抗生素 ;加强支持疗法增强病人机体免疫力尤为重要。

Objective To explore the clinical features of the patients with severe cranial trauma complicated with pulmonary infections. Methods Retrospective studies were conducted on the 153 such cases from March 1`997 to October 1999. Results The occurrence rate of the pulmonary infection was 67.42% in all the severe cranial traumas cases .19 kinds of bacteria were revealed , among whom Gram negative accounted for 81.43%, Gram positive accounted for 18.57%. The total therapeutic efficacy was 84.31%. Conclusion Pulmonary infection was the second factor affecting the cranial traumas with high occurrence 、complicated pathogenesis and varieties of bacteria. The therapy should be based on the drug sensitivity and supportive treatment to raise the immune functions of the patients.