摘要
目的探讨脑出血合并肺部感染患者的病原菌分布情况、危险因素及急救护理的应用效果。方法选取157例于河北医科大学第一医院就诊的脑出血合并肺部感染者为本次研究对象,同时随机选取85例同期脑出血未发生肺部感染者为未感染组。采用一次性无菌吸痰管采集脑出血合并肺部感染患者咽喉深部痰液标本,接种于培养皿培养后进行分离,利用全自动细菌分析仪进行病原菌鉴定。按照CLSI中的方法进行真菌药敏试验和判读。将157例脑出血合并肺部感染患者利用数字抽签法分为观察组和对照组。对照组患者采用常规干预,观察组患者在常规干预基础上加用急救程序化管理干预。比较两组患者的出诊反应时间、心电图时间、急救总时间、急救诊断率、急救成功率。对比157例脑出血合并肺部感染患者与85例未发生肺部感染的脑出血患者的临床资料,分析脑出血患者合并肺部感染的危险因素。结果共检出病原菌157株。革兰阴性菌110株,以肺炎克雷伯菌(47/157,29.94%)、铜绿假单胞菌(24/157,15.29%)、鲍曼不动杆菌(17/157,10.83%)为主。革兰阳性菌33株,以肺炎链球菌(15/157,9.55%)、金黄色葡萄球菌(11/157,7.01%)为主。真菌14株,以白色假丝酵母菌(12/157,7.64%)为主。对本次研究检出的14株真菌进行药敏试验发现,对伊曲康唑的耐药率最高为28.57%,对两性霉素B较敏感,耐药率为7.14%,未发现对氟胞嘧啶的耐药株。对比感染组与未感染组患者临床资料,术前呕吐、糖尿病史、术前GCS评分、插管时间、机械通气时间、气管切口、低蛋白血症对脑出血并发肺部感染的影响具有统计学意义(P<0.05)。进行二元Logistic多元素分析发现,术前呕吐、术前GCS评分9~12分、插管时间>3d、机械通气时间>24h、气管切口是脑出血并发肺部感染的独立危险因素。对照组采用常规干预治疗,观察组在常规干预基础上加
Objective To explore the distribution of pathogenic bacteria,risk factors and the effect of emergency nursing in patients with cerebral hemorrhage complicated with pulmonary infection.Methods 157 patients with intracerebral hemorrhage and pulmonary infection who were treated in the First Hospital of Hebei Medical University were selected as the subjects of this study,and 85 patients with intracerebral hemorrhage without pulmonary infection during the same period were randomly selected as the non-infected group.The sputum samples were collected by disposable sterile sputum suction tube from the throat of patients with cerebral hemorrhage and pulmonary infection,inoculated in the petri dish for culture,and then isolated,and the pathogen was identified by automatic bacterial analyzer.Fungal drug sensitivity test was carried out according the method in CLSI.157 patients with cerebral hemorrhage and pulmonary infection were divided into observation group and control group by digital lottery.The patients in the control group were treated with routine intervention,and the patients in the observation group were treated with emergency procedural management intervention on the basis of routine intervention.The response time,ECG time,total emergency time,emergency diagnosis rate and emergency success rate of the two groups were compared.The clinical data of 157 patients with cerebral hemorrhage complicated with pulmonary infection and 85 patients with cerebral hemorrhage without pulmonary infection were compared to analyze the risk factors of cerebral hemorrhage complicated with pulmonary infection.Results A total of 157 strains of pathogenic bacteria were detected.There were 110 gram-negative bacteria,mainly Klebsiella pneumoniae(47/157,29.94%),Pseudomonas aeruginosa(24/157,15.29%)and Acinetobacter baumannii(17/157,10.83%).There were 33 strains of gram-positive bacteria,mainly Streptococcus pneumoniae(11/157,9.55%)and Staphylococcus aureus(11/157,7.01%).There were 14 fungi,mainly Candida albicans(12/157,7.64%).The drug sen
作者
刘少俊
贾维宁
韩亚静
李娜
张乐乐
LIU Shaojun;JIA Weining;HAN Yajing;LI Na;ZHANG Lele(The First Hospital of Hebei Medical University,Shijiazhuang 050031,China;Zhangjiakou University)
出处
《中国病原生物学杂志》
CSCD
北大核心
2023年第6期725-728,733,共5页
Journal of Pathogen Biology
关键词
脑出血
肺部感染
危险因素
急救护理
cerebral hemorrhage
lung infection
risk factors
emergency care
