重症监护病房患者合并肺部感染的临床特征探讨

Clinical Characteristics of Patients with Pulmonary Infection in Intensive Care Unit

目的:探讨重症监护病房患者合并肺部感染的特点及防治措施。方法:回顾性分析61例重症监护病房中肺部感染患者相关资料。结果:表现为咳嗽、咳痰、发热等典型肺部感染者40例(65.57%),不典型表现21例(34.43%);61例患者中合并各种并发症43例(70.49%),合并两种以上并发症17例(27.87%)。肺部感染组平均年龄(62.23±11.43)岁、实施有创操作91.80%、应用麻醉镇静药88.52%、预防应用抗生素45.90%、住监护病房时间(16.27±5.34)d,高于无肺部感染组的(50.23±12.09)岁、54.10%、65.57%、18.03%、(10.45±4.75)d,白蛋白水平(30.29±4.13)g/L,低于无肺部感染组的(33.42±3.53)g/L(P<0.05),均为引起肺部感染的危险因素。61例患者均进行痰培养132例次,阳性80例次(60.61%):革兰氏阴性菌47例次(58.75%)、革兰氏阳性球菌23例次(28.75%)、真菌10例次(12.50%);二种及以上混合性感染12例次(15.00%);死亡8例(13.11%)。结论:肺部感染在重症监护病房患者中发生率较高,临床表现、影响因素、病原菌构成具有一定特异性,应重视监护病房肺部感染问题,实施切实可行措施,减少肺部感染的发生。

Objective：To investigate the characteristics and prevention measures of pulmonary infection in intensive care unit（ICU） patients.Method：The tatal of 61 patients with pulmonary infection in ICU were analyzed retrospectively.Result：The clinical manifestations were cough,expectoration,fever and other typical pulmonary infection 40 cases（65.57%）,atypical manifestations 21 cases（34.43%）;61 cases with complications 43 cases（70.49%）,with more than two kinds of complications 17 cases（27.87%）.The average age of lung infection（62.23±11.43）years of age,invasive operation 91.80%,applications of anaesthetic 88.52%,prophylactic use of antibiotics 45.90%,staying in ICU time（16.27±5.34）days,higher than in the non pulmonary infection group（50.23±12.09）years,54.10%,65.57%,18.03%,（10.45±4.75）days（P〈0.05）,the level of albumin（30.29±4.13）g/L,lower than non pulmonary infection group（33.42±3.53）g/L（P〈0.05）,which was the risk factors of pulmonary infection.The 61 patients were 132 cases of positive sputum culture,positive 80 cases（60.61%）,gram negative bacteria 47 cases（58.75%）,gram positive cocci 23 cases（28.75%）,fungi 10 cases（12.50%）;two or more mixed infection 12 cases（15%）;8 cases death（13.11%）.Conclusion：The higher the incidence of pulmonary infection in ICU patients,clinical manifestations,influencing factors,pathogens are specific,should be attention to lung infection in ICU,the implementation of feasible measures to reduce the incidence of pulmonary infection.