摘要
目的分析脑干出血患者合并医院感染的主要类型,探讨其防治策略,为减少住院脑干出血患者医院感染发生率及改善预后提供方法。方法回顾性分析2012年1月-2013年1月神经内科重症监护病房(NICU)35例确诊为脑干出血医院感染的患者,分析其医院感染的类型,病原菌及治疗途径和效果,并与同病房非脑干型脑出血患者55例医院感染的患者进行对照。结果脑干出血35例患者中发生医院感染32例,感染率为91.4%,非脑干型脑出血55例患者中发生医院感染13例,感染率为23.6%,差异有统计学意义(χ2=34.28,P<0.01);35例脑干出血患者中有17例患者合并≥2种系统感染,感染58例次,以肺部感染最多30例次,其次为尿路感染18例次和菌血症10例次,分别占51.7%、31.1%、17.2%,非脑干型脑出血患者尿路感染10例,呼吸系统感染3例,分别占76.9%、23.1%,与非脑干型脑出血患者相比,脑干出血患者医院感染率显著增高(P<0.01);痰培养结果显示,病原菌以革兰阴性杆菌为主占62.5%,其中以铜绿假单胞菌最为常见,占28.1%。结论脑干出血患者医院感染率高,以肺部感染为主,早期有效地预防性抗菌药物治疗可控制感染率,降低脑干出血患者的病死率。
OBJECTIVE To analyze the main types of nosocomial infections in patients with brainstem hemorrhage and discuss the control strategy, so as to provide methods to reduce nosocomial infection incidence in hospitalized patients with brain stem hemorrhage and improve prognosis. METHODS A total of 35 patients diagnosed as nosocomial infections with hemorrhage of brain stem in the intensive care unit of the Department of Neurology of our hospital from Jan. 2012to Jan. 2013 were analyzed retrospectively with the type of nosocomial infections, germs, treatment pathways and effects. Another 55 patients with nosocomial infections who were non-brainstem cerebral hemorrhage in the same ward were compared with the 35 patients. RESULTS Among the 35 patients with hemorrhage of brain stem, 32 patients （91.4 %） got nosocomial infections, while among the 55 patients with non- brainstem cerebral hemorrhage, 13 patients （23.6 %） got nosocomial infections, and the difference was significant （Х^2 =34.28,P〈0.01 ）. Among the 35 patients with hemorrhage of brain stem, 17 patients got co-infections more than 2 systems and there are 58 times of infections, pulmonary infection 30 times, urinary tract infection 18 times and bacteremia 10 times, accounting for 51.7%, 31.1%, 17.2%, respectively. There were 10 times of urinary tract infections, 3 times of respiractory tract infections in patients with non-brainstem cerebral hemorrhage, accounting for 76.9%, 23. 1% respectively. Compared with non-brainstem patients with cerebral hemorrhage, brain stem hemorrhage in patients with nosocomial infection was significantly higher （P〈0.01）. The results of sputum culture showed that the main pathogenic bacteria were gram-negative bacilli, accounting for 62. 5%, among which Pseudornonas aeruginosa was the most common one, accounting for 28.1%. CONCLUSION Patients with brain stem hemorrhage are in high risk of nosocomial infections, and lung infection is the top one. Effective treatment using preventive antibiotics in early time can ef
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第11期2727-2728,2731,共3页
Chinese Journal of Nosocomiology
基金
唐山市科技局基金资助项目(12130223b)
关键词
脑干出血
患者
医院感染
分析
Brainstem hemorrhage
Patients
Nosocomial infections
Analysis
