摘要
目的探讨I CU内脑外伤患者院内肺部感染的危险因素,为院内感染提供科学依据。方法对220例ICU重型颅脑外伤患者的临床诊治资料进行分析。结果出现肺部感染51例,分离出病原菌80株,其中革兰阴性菌56株,占70.0%,革兰阳性菌20例,占25.0%,真菌4株,占5.0%。ICU重型颅脑外伤出现肺部感染的发生率高,其与通气时间、革兰阴性杆菌感染和抗生素耐药有关。其敏感的抗菌药物为亚胺培南/西司他丁、头孢呱酮/舒巴坦、阿米卡星;耐亚胺培南/西司他丁革兰阳性球菌对万古霉素、复方新诺明敏感;真菌感染对氟康唑耐药增多,对斯皮仁诺仍敏感。经过治疗,所有病例均完全缓解。结论严格掌握抗生素应用范围、指征,禁止滥用抗生素,建立严格的保护性隔离措施,积极治疗脑外伤,减少院内肺部感染极其重要。
Objective To explore the probability and risk factors of the lung hospital infection （LHI） of brain injury patients in ICU, .so as to provide the evidence for preventing and controlling LHL. Methods The clinical data of 220 high brain injury patients in ICU were collected and analyzed statistically. Results A total of 51 patients occurred pulmonary infection, and the 80 pathogen strains were isolated, including 56 strains of gram-negative bacteria, （70.0 % ）, 20 cases of gram positive bacteria （25.0 % ）, and 5 fungus strains （5.0 % ）. The risk factors included respiratory machine application, respiratory tract incision, and shock. Vancomycin and SMZ-TPM were also effective to the resistance-imipenem/cilastatin sodium gram-positive bacilli. Fungal infection was more resistant to fluconazole, but was sensitive to itraconazole. Conclusions There are multi-drug resistance and multi-infection in the cases of this study. We should use antibiotics properly, establish the strict protection, and treat brain trauma properly.
出处
《中国校医》
2013年第11期842-843,共2页
Chinese Journal of School Doctor
关键词
颅脑损伤
肺疾病
并发症
肺疾病
病因学
加强医疗病房
Craniocerebral Trauma
Lung Disease/complication
Lung Disease/etiology
Intensive Care Unit
