摘要
目的了解高血压性脑出血患者术后下呼吸道感染的病原菌分布特征,并分析引发下呼吸道感染的相关危险因素。方法对2015年8月-2016年8月医院1000例高血压性脑出血患者术后临床资料进行回顾性分析,对医院感染率、病原菌分布特征、下呼吸道感染的危险因素进行分析。结果 1 000例高血压性脑出血患者术后发生下呼吸道感染143例,感染率为14.30%;143例下呼吸道感染患者中,83例痰培养阳性,阳性率为58.04%;共分离出病原菌224株,其中革兰阴性菌142株占63.39%,革兰阳性菌48株占21.43%,真菌34株占15.18%;单因素分析显示,年龄≥65岁、有侵入性诊疗、住院时间>14d、血糖水平>7.8mmol/L、合并基础性疾病者下呼吸道感染率明显高于年龄<65岁、无侵入性诊疗、住院时间≤14d、血糖水平≤7.8mmol/L、无基础性疾病者,差异有统计学意义(P<0.05);年龄、侵入性诊疗、住院时间、血糖水平、基础性疾病是高血压性脑出血患者术后下呼吸道感染独立危险因素。结论高血压性脑出血患者术后下呼吸道感染率较高,以革兰阴性菌感染为主,应加强抗菌药物的合理应用,针对其相关因素进行预防,对降低下呼吸道感染具有重要作用。
OBJECTIVE To understand the distribution of pathogens causing postoperative lower respiratory tract infection in patients with hypertensive cerebral hemorrhage and analyze the related risk factors for the postoperative lower respiratory tract infection.METHODS The postoperative clinical data of 1000 patients with hypertensive cerebral hemorrhage who were treated in the hospital from Aug 2015 to Aug 2016 were retrospectively analyzed.The incidence of nosocomial infections,distribution of pathogens,and risk factors for the lower respiratory tract infection were observed.RESULTS Of the 1 000 patients with hypertensive cerebral hemorrhage,143 had postoperative lower respiratory tract infection,with the infection rate 14.30%;the sputum specimens were cultured positive in 83 of 143patients with lower respiratory tract infection,with the positive rate 58.04%.A total of 224 strains of pathogens were isolated,including 142（63.3%）strains of gram-negative bacteria,48（21.43%）strains of gram-positive bacteria,and 34（15.18%）strains of fungi.Univariate analysis indicated that the incidence rate of lower respiratory tract infection was significantly higher in the patients with no less than 65 years of age,invasive operations,length of hospital stay more than 14 days,blood glucose level more than 7.8mmol/L,and complication with underlying diseases than in the patients with less than 65 years of age,without invasive operations,length of hospital stay no more than 14 days,blood glucose level no more than 7.8mmol/L,and without underlying diseases（P〈0.05）.The independent risk factors for the postoperative lower respiratory tract infection in the patients with hypertensive cerebral hemorrhage included the age,invasive operations,length of hospital stay,blood glucose level,and underlying diseases.CONCLUSION The incidence rate of postoperative lower respiratory tract infection is relatively high in the patients with hypertensive cerebral hemorrhage,the gram-negative bacteria are dominant among the pathogens causing the
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第9期2020-2023,共4页
Chinese Journal of Nosocomiology
基金
河南省科技攻关基金资助项目(132103320198)
关键词
高血压
脑出血
下呼吸道感染
相关因素
Hypertension
Cerebral hemorrhage
Lower respiratory tract infection
Related factor
