ICU病房重度颅脑损伤并发肺部感染的危险因素和防治措施

Risk factors and control measures for ICU patients with severe brain injury and pulmonary infection

目的探讨重度颅脑损伤患者在重症监护病房(ICU)住院期间并发肺部感染的危险因素和防治措施。方法回顾性分析我院ICU住院35例重度颅脑损伤患者并发肺部感染的临床资料,分析其病原菌、易感因素及耐药性。结果 117例同期收治重度颅脑损伤患者,35例(29.9%)合并肺部感染,分离出32株病原菌,其中23例(71.9%)病原菌为革兰氏阴性杆菌,7例(21.9%)兰氏阳性球菌,2例(6.2%)为真菌感染。气管切开、卧床住院超过20天、气管插管使用呼吸机、基础性疾病等为肺部感染的危险因素。结论加强控制相关危险因素,可能有效减少ICU病房重度颅脑损伤并发肺部感染。

Objective To investigate the risk hctors and control measures for patients with severe brain injury and pulmonary infection in intensive care unit （ICU）. Methods The clinical data of 35 patients with severe brain injury and pulmonary infection were analyzed retrospectively, mainly analyze the pathogen, susceptible factors and tolerance. Results 35 （29.9%） patients in 117got pulmonary infection. 32 strains of pathogenic bacteria was isolated, 23 strains were Gram negative bacillus （71.9%）,7strains were Gram-positive Cocci （21.9%） and 2strains were fungus （6.2%）. Risk factors for pulmonary infection were traeheotomy, stay in hospital for more than 20 days, endotracheal intuhation using breathing machine and basic disease. Conclusions Strengthen the control of associated risk factors, can effectively reduce the occurrence of pulmonary infection for patients with severe craniocerebral injury in ICU.