颅脑损伤患者术后并发肺部感染的危险因素分析

Risk factors of postoperative pulmonary infection in patients with traumatic brain injury

目的 对颅脑损伤(TBI)术后肺部感染的发生率及肺部感染的危险因素进行分析,以期明确TBI术后肺部感染的危险因素及高危人群,为TBI术后肺部感染防治方案的制定提供更多依据和支持。方法 选取2019年6月—2022年6月行手术治疗的200例TBI患者作为研究对象,对其临床资料进行回顾性分析。结果 TBI患者后肺部感染发生率为30.00%(60/200);经单因素结果:年龄、手术风险、术前GCS评分、手术次数、手术持续时间、气管插管或切开、机械通气时间、免疫抑制剂的使用、误吸、引流管、入住ICU时间、术后低蛋白血症均会影响TBI术后肺部感染的发生(P<0.05);多因素结果:高龄、手术次数≥2次、手术持续时间长、进行气管插管或切开操作、机械通气时间长、发生误吸、留置引流管、入住ICU时间长、术后合并低蛋白血症均为TBI术后发生肺部感染的危险因素(P<0.05)。结论 TBI术后发生肺部感染受多种因素影响,因此,在患者入院后应对其进行综合评估和分析,对于高危人群应尽早采取措施,以降低TBI术后肺部感染的发生率,提升患者预后。

Objective To analyze the incidence and risk factors of pulmonary infection after traumatic brain injury(TBI)surgery,in order to identify the risk factors and high-risk population of pulmonary infection after TBI surgery,and to provide more basis and support for the development of prevention and treatment plans of pulmonary infection after TBI surgery.Methods A total of 200 TBI patients who underwent surgical treatment from June 2019 to June 2022 were selected as study subjects,and their clinical data were retrospectively analyzed.Results The incidence of pulmonary infection after TBI was 30.00%(60/200).Univariate results showed that age,surgical risk,preoperative GCS score,surgical times,surgical duration,endotracheal intubation or incision,mechanical ventilation time,use of immunosuppressive agents,aspiration,drainage tube,ICU stay time,and postoperative hypoproteinemia were significantly different between the pulmonary infection group and the non-pulmonary infection group(P<0.05).Multivariate results showed that advanced age,≥2 operations,long operation duration,endotracheal intubation or incision,long mechanical ventilation time,aspiration,indwelling drainage tube,long ICU stay time,and postoperative hypoproteinemia were all risk factors for pulmonary infection after TBI(P<0.05).Conclusion The occurrence of pulmonary infection after TBI is affected by many factors.Therefore,comprehensive evaluation and analysis should be carried out after admission,and measures should be taken as early as possible for high-risk groups to reduce the incidence of pulmonary infection after TBI and improve the prognosis of patients.