高血压脑出血患者小骨窗开颅术治疗后发生肺部感染影响因素分析

Influence Factors Analysis of Pulmonary Infection in Hypertensive Cerebral Hemorrhage Patients after Small Bone Window Craniotomy

目的研究高血压脑出血患者小骨窗开颅术治疗后发生肺部感染的相关因素及防治措施的效果。方法将2011年1月至2013年12月在内江市第二人民医院接受小骨窗开颅术治疗的240例高血压脑出血患者纳入研究,给予肺部感染综合防治措施并进行前瞻性研究,分析患者自身情况、手术治疗情况、药物治疗情况等相关因素与肺部感染的关系,比较综合感染防治措施前后的肺部感染情况。结果 240例高血压脑出血患者中共发生肺部感染53例,感染率为22.1%;多因素Logistic回归分析结果显示,高龄、严重昏迷、择期手术、骨窗偏大、机械通气时间延长、使用广谱抗生素和糖皮质激素、低蛋白血症是高血压脑出血患者术后肺部感染的危险因素(P<0.05)。结论高血压脑出血患者小骨窗开颅术治疗后肺部感染的发生受到自身情况、手术治疗以及药物治疗情况等多种因素的共同影响。

Objective To study the influence factors of pulmonary infection in hypertensive cerebral hemorrhage patients after small bone window craniotomy. Methods Total of 240 hypertensive cerebral hemorrhage patients who received small bone window craniotomy in Neijiang City Second People＇s Hospital from Jan. 2011 to Dec. 2013 were enrolled and prospectively studied. Then incidence of pulmonary infection was observed,correlation between patient self-condition,operation treatment,drug treatment and pulmonary infection were analyzed,and the pulmonary infection before and after comprehensive preventive measures was compared. Results Among the 240 cases of 240 hypertensive cerebral hemorrhage,53 cases had pulmonary infection,the infection rate was 22. 1%. Logistic regression analysis showed that old age,severe coma,elective operation,large bone window,prolonged mechanical ventilation,use of broad-spectrum antibiotics and corticosteroids,and hypoproteinemia were risk factors of pulmonary infection（ P〈0. 05）. Conclusion Pulmonary infection in hypertensive cerebral hemorrhage patients after small bone window craniotomy is affected by many factors including self-condition,operation therapy and drug treatment etc.