摘要
目的 探究重型颅脑损伤患者的肺部感染特点及吸烟史、机械通气及基础疾病等影响。方法 回顾性分析本院2020年12月—2021年12月收治的206例重型颅脑损伤患者的资料,依据是否合并肺部感染分为感染组与未感染组。观察感染组病原菌分布与耐药性情况,分析影响肺部感染的相关因素。结果 141例重型颅脑损伤合并肺部感染患者中革兰阴性菌181株,革兰阳性菌79株。肺部感染病原菌表现出多重耐药性。住院时间≥21 d、存在肺部基础疾病、气管切开、机械通气、昏迷时间>24 h、PCT、CRP为重型颅脑损伤合并肺部感染的独立性危险因素(P<0.05)。结论 重型颅脑损伤合并肺部感染以革兰阴性菌为主,应合理选取适合的抗菌药物治疗。住院时间≥21 d、存在肺部基础疾病、气管切开、机械通气、昏迷时间>24 h、血清PCT、CRP均为合并肺部感染的危险因素,需引起临床重视。
Objective This paper aims to explore the characteristics of pulmonary infection and the influence of smoking history, mechanical ventilation and underlying diseases in patients with severe craniocerebral injury. Methods The data of 206 patients with severe craniocerebral injury admitted to our hospital from December 2020 to December 2021 were retrospectively analyzed, and they were divided into an infected group and an uninfected group according to whether they were complicated with pulmonary infection. The distribution and drug resistance of pathogenic bacteria in the infected group were observed, and the related factors affecting pulmonary infection were analyzed. Results Among the 141 patients with severe craniocerebral injury complicated with pulmonary infection, there were 181 strains of gram-negative bacteria and 79 strains of gram-positive bacteria. The pathogenic bacteria in lung infection show multidrug resistance. Hospitalization time ≥21 d, existence of pulmonary underlying disease, tracheotomy, mechanical ventilation, coma time>24 h, PCT, CRP were independent risk factors for severe craniocerebral injury complicated with pulmonary infection(P<0.05). Conclusion Severe craniocerebral injury complicated with pulmonary infection is mainly caused by gram-negative bacteria, and appropriate antibiotics should be selected reasonably for treatment. Hospitalization time ≥21 d, underlying lung diseases, tracheotomy, mechanical ventilation, coma time > 24 h, serum PCT and CRP are all risk factors for pulmonary infection, which need to be paid attention to.
作者
杨睿
陈腾飞
李占江
YANG Rui;CHEN Teng-fei;LI Zhan-jiang(Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Zhengzhou University,Henan 450000,China)
出处
《中国卫生检验杂志》
CAS
2023年第3期357-360,共4页
Chinese Journal of Health Laboratory Technology
基金
河南省医学科技攻关计划项目(LHGJ20190209)。
关键词
重型颅脑损伤
肺部感染
病原菌
吸烟史
机械通气
基础疾病
影响因素
Severe craniocerebral injury
Pulmonary infection
Pathogenic bacteria
Smoking history
Mechanical ventilation
Underlying diseases
Influencing factors
