重度颅脑外伤患者肺部感染的危险因素及干预措施

Risk factors and intervention strategies for pulmonary infection in patients with severe brain trauma

目的探讨重度颅脑外伤患者肺部感染危险因素,并采取相对应的处理措施,以期提高临床治疗水平。方法回顾性分析2009年7月-2013年7月90例重度颅脑外伤患者,对其中29例发生肺部感染患者进行危险因素分析,采用SPSS13.0软件对数据进行统计分析。结果 90例重度颅脑外伤患者中29例发生肺部感染,感染率为32.22%;共检出病原菌109株,其中革兰阴性菌占72.48%、革兰阳性菌占24.77%、真菌占2.75%;年龄>60岁、GCS评分、有基础疾病、气管切开、抗菌药物及激素应用、休克是重度颅脑外伤合并肺部感染高危险因素(P<0.05)。结论充分做好入院相关准备且积极预防治疗可降低重度颅脑外伤合并肺部感染的发生。

OBJECTIVE To investigate risk factors for pulmonary infection in patients with severe brain trauma,and take corresponding countermeasures in order to improve the level of clinical treatment.METHODS Totally 90 patients with severe brain trauma during Jul.2009 to Jul.2013 were retrospective analyzed,among which 29 patients accompanied by pulmonary infections were analyzed for risk factors.Data were statistically analyzed with SPSS 13.0software.RESULTS There were 29cases（32.22%）of pulmonary infections in the 90 patients with severe brain trauma.Totally 109 strains of pathogens were detected,including gram-negative bacteria（72.48%）,gram-positive bacteria（24.77%）,and fungi（2.75%）.Age〉60scores,GCS scores,underlying diseases,tracheotomy,antibiotics and hormone application,and shock were the high risk factors for severe brain trauma accompanied by pulmonary infections（P〈0.05）.CONCLUSIONS Full preparation for hospitalization and active preventive treatment can reduce the occurrence of severe brain trauma accompanied by pulmonary infections.