创伤患者肺部感染的临床探讨

Clinical study of pulmonary infection in traumatic patients

目的探讨外科创伤住院患者肺部感染的临床特点、病原菌及药敏情况。方法对2013年6月至2014年12月重庆市丰都县中医院外伤住院患者肺部感染的疾病特点、病原学临床检查、治疗方法进行回顾性分析。结果肺部感染患者临床症状多不典型。实验室检查WBC〉10.0×109/L 31例、（4~10）×109/L 32例、〈4.0×109/L 0例;中性粒细胞比例（N）〉70%55例,50%~70%8例,〈50%0例。明确病原菌诊断51例（81.0%）,经痰培养获得46例,血培养获得12例。肺部感染以细菌感染为首,占68.3%,主要为革兰阴性菌,其中单一细菌感染15例,复合细菌感染23例,合并真菌感染15例。结论外科创伤患者救治成功率受制于创伤后肺部感染和复杂耐药性等因素的共同作用,因此临床检查起到很重要的作用。

Objective To investigate the clinical characteristics,pathogenic bacteria detection rate and drug sensitivity situation of pulmonary infection in surgical trauma inpatients.Methods The characteristics,pathogenic clinical examination and treatment method of pulmonary infection among traumatic inpatients in Fengdu County Hospital of Traditional Chinese Medicine from June2013 to December 2014 were retrospectively analyzed.Results The clinical symptoms of pulmonary infection were usually atypical.The laboratory detection showed 31 cases of WBC〉10.0×109/L,32 cases of（4-10）×109/L,0case of4.0×109/L,and 55 cases of neutrophils proportion〉70%,8cases of neutrophils proportion 50%-70% and 0case〈50%.51cases（81%）were definite in pathogenic diagnosis,in which 46 cases were obtained by sputum culture and 12 cases were obtained from blood culture.Lung infections were mainly caused by bacterial infections（68.3%）,which was nominated by Gram-negative bacteria,including 15 cases of single bacterial infections,23 cases of complex bacterial infection and 15 cases of complicating fungal infection.Conclusion The treatment success rate of surgical trauma patients is affected by the combined action of lung infection and complicated drug resistance,so the clinical examination plays a very important role.