颅脑损伤开颅术后患者肺部感染的相关因素研究

Study on related factors of pulmonary infection in patients with craniocerebral injury after craniotomy

目的探讨开颅术后患者肺部感染的危险因素。方法选取2021年3月至2023年4月在郑州大学第一附属医院收治的颅脑损伤开颅术患者134例,根据患者开颅术后是否发生肺部感染将患者分为未感染组和感染组。收集患者的性别、年龄、脑损伤类型等病历信息并进行分析。结果开颅术后发生肺部感染率34.81%,未感染率64.44%;对患者的肺部感染原因进行单因素分析后发现,感染组和未感染组患者在美国麻醉医师协会(ASA)分级、脑损伤类型、格拉斯哥昏迷指数(GCS)评分、手术时间、术前血糖、气管是否切开、使用抗菌药物时间、术中失血量、手术后7天内血清白蛋白含量、降钙素原含量、C-反应蛋白含量、使用呼吸机时间以及是否预防性应用抗菌药物等方面差异有统计学意义(P<0.05)。多因素logistic分析结果发现GCS评分、术前血糖含量、手术后卧床时间、气管是否切开、呼吸机使用时间以及是否使用抗菌药物均为开颅术后发生肺部感染的危险因素。结论颅脑损伤开颅术后患者可能会出现肺部感染,并且与多个因素密切相关,包括GCS评分、术前血糖含量、手术后卧床时间、是否切开气管、呼吸机使用时间以及使用抗菌药物等。在临床工作中,应该特别注意预防和治疗这类问题的工作。这样有助于降低患者发生肺部感染的风险,并提高治疗效果。

Objective To explore the risk factors of pulmonary infection in patients after craniotomy.Methods Totally 134 patients with craniotomy for craniocerebral injury admitted to the First Affiliated Hospital of Zhengzhou University from March 2021 to April 2023 were selected.Patients are divided into uninfected and infected groups based on whether they have experienced pulmonary infection after craniotomy.Collect and analyze medical record information such as gender,age,and type of brain injury of patients.Results The pulmonary infection rate after craniotomy was 34.81%,and the non-infection rate was 64.44%.After a single factor analysis of the cause of lung infection in patients,There were statistically significant differences in ASA grade,brain injury type,GCS score,operation time,preoperative blood glucose,tracheotomy or not,antibiotic use time,intraoperative blood loss,serum albumin content,procalcitonin content,C-reactive protein content within 7 days after operation,ventilator use time,and antibiotic prophylactic use(P<0.05).Multivariate logistic analysis showed that GCS score,preoperative blood glucose content,bed time after surgery,tracheotomy or not,ventilator use time and antibiotic use were all risk factors for pulmonary infection after craniotomy.Conclusion The complications of pulmonary infection in patients after craniotomy are closely related to GCS score,preoperative blood sugar content,postoperative bed rest time,whether the trachea is cut open,the duration of ventilator use,and the use of antibiotics.In clinical work,attention should be paid to the prevention and treatment of such problems.