神经外科患者并发肺部感染的相关因素分析

Factors for pulmonary infection in patients with neurosurgical diseases

目的分析神经外科患者并发肺部感染的相关因素,为临床降低肺部感染率提供参考。方法统计2015年1月-2018年5月作者所在医院神经外科2190例患者一般情况、临床表现、手术相关及实验室等资料,分析肺部感染的发生率及影响因素。结果2190例患者中肺部感染158例(7.2%),性别差异无统计学意义(P>0.05);年龄≥60岁、重度意识障碍、血清白蛋白>40 g/L、住院时间>14天、行气管插管或切开、使用呼吸机、手术创伤、糖尿病、吸烟史、预防性使用抗生素、鼻饲饮食与肺部感染关系密切(P<0.05)。多因素分析结果显示年龄、意识障碍、血清白蛋白、住院时间、气管插管或切开、使用呼吸机、糖尿病、吸烟史、预防性使用抗生素均为独立相关因素(P<0.05)。结论加强对患者肺部感染相关因素的重视与监控,有利于指导临床制定治疗措施,降低神经外科住院患者肺部感染发生率。

Objective To investigate the factors for pulmonary infection in patients with neurosurgical diseases,and to provide a reference for reducing pulmonary infection rate in clinical practice. Methods A retrospective analysis was performed for the clinical data of 2 190 patients in Department of Neurosurgery in our hospital from January 2015 to May 2018,including general status,clinical manifestations,surgical data,and laboratory data. The incidence rate of pulmonary infection and related influencing factors were analyzed. Results Among the 2 190 patients,158( 7. 2%) had pulmonary infection,and there was no significant difference between male and female patients( P > 0. 05). An age of ≥60 years,severe disturbance of consciousness,a serum albumin level of >40 g/L,a length of hospital stay of > 14 days,tracheal intubation or incision,respirator therapy,surgical trauma,diabetes mellitus,a history of smoking,prophylactic use of antibiotics,and nasogastric feeding were closely associated with pulmonary infection( P <0. 05). The multivariate analysis showed that age,disturbance of consciousness,serum albumin,length of hospital stay,tracheal intubation or incision,ventilator therapy,diabetes mellitus,a history of smoking,and prophylactic use of antibiotics were independent factors( P < 0. 05). Conclusions The factors for pulmonary infection should be closely monitored in patients,which may help to develop clinical treatment measures and reduce the incidence rate of pulmonary infection in hospitalized patients in department of neurosurgery.