开颅手术后并气管切开后多重耐药菌感染并低热的病例讨论

After surgical operation and multiple drug-resistant bacteria infection after tracheotomy and low thermal cases discussion

目的:探讨开颅术后气管切开后多重耐药菌低热治疗体会。方法:回顾性分析我科收治开颅术后气管切开后多重耐药菌感染并低热的病例讨论5例的临床资料。结果:该5例因高血压脑出血、重型颅脑损伤、动脉瘤后蛛网膜下腔出血行颅内血肿清除术、去骨瓣减压术及侧脑室引流术,术后因痰多或意识障碍行气管切开术。痰培养均为多重耐药并依照药敏结果选用敏感抗生素治疗后但患者体温在37-38℃波动,停用抗生素后患者体温下降肺部感染情况好转。结论:开颅术后气管切开后多重耐药菌感染应用敏感抗生素并低热,如能征得患者家属同意,停用抗生素姑息治疗不失一种不错的治疗方案。

Objective： To study the open brain surgery after tracheotomy low thermal treatment multi-resistant bacteria. Methods： Analysis of five cases admitted in neurosurgery we open a brain surgery and after tracheotomy and patients with multiple drug-resistant bacteria infection, after the use of antibiotics is still a low grade fever. Results： The 5 patients with hypertension cerebral hemorrhage, severe head injury, aneurysm subarachnoid hemorrhage after craniotomy surgery, postoperative tracheotomy because of sputum more or in a coma. These patients with sputum bacterial culture results show that the multiple drug resistance. According to choose sensitive antibiotic susceptibility results after treatment, the patient body temperature in 37-38℃. Stop using antibiotics in patients after temperature decreased gradually and pulmonary infection conditions improve. Conclusion： After surgical operation and the patients with tracheotomy, multiple drug-resistant bacteria infection patients. According to the result of sputum bacterial culture choose sensitive antibiotic treatment there is still a low grade fever. Get the patients＇ families agreed not to cause legal dispute, stop using antibiotics do not break a good palliative care treatment.