重度颅脑伤患者下呼吸道双重感染防治的临床研究  

Analysis of risk factors in patients with superinfection in lower respiratory tract after serious cerebral injuries

作　　者：张建军[1] 董伟峰[1] 朱镇宇[1] 顾水均[1] 张俊[1] 

机构地区：[1]浙江省萧山市第一人民医院,浙江萧山311201

出　　处：《中国危重病急救医学》2001年第5期299-301,共3页Chinese Critical Care Medicine

基　　金：浙江省萧山市科技计划资助项目! (No.2 0 0 0 2 2 1)

摘　　要：目的 :探讨重度颅脑伤后下呼吸道双重感染的相关因素及防治对策。方法 :对格拉斯哥昏迷评分(GCS)≤ 8分 6 72例重度颅脑伤中发生下呼吸道双重感染病例进行相关危险因素的统计分析。结果 :32例发生下呼吸道双重感染 ,原发伤重、高龄、营养状况差是患者自身的危险因素 ;治疗中可能引起下呼吸道感染的因素如手术、人工气道或机械通气及时间长短、广谱抗生素、大剂量激素的应用及应激性高血糖等均是引起双重感染的医源性危险因素。结论 :加强对高龄患者的监测 ,迅速、合理处理原发伤及应激性高血糖 ,加强营养支持 ,确切掌握人工气道、机械通气应用指征 ,合理应用抗生素及激素是防治双重感染的关键。Objective:Through analysis of risk factors of superinfection in the lower respiratory tract after severe cerebral injuries to develop a strategy for the prevention and treatment of this serious complication.Methods:The risk factors in 672 cases of serious cerebral injuries (GCS≤8) who had superinfection in the lower respiratory tract were analyzed.Results:Thirtytwo of the 672 cases had superinfection in the lower respiratory tract.The seriousness of injuries,old age,nutritional condition were the inherent risk factors.Other factors such as operation,artificial airway or mechanical respiration,antibiotics,large dosage hormone,and high blood sugar level after stress were the therapyrelated factors.Conclusions:Strengthened monitoring in elderly patients,proper treatment of the injuries and original disease,intensified nutrition support,proper care of artificial airway,appropriate use of antibiotics and hormone are all the keys to reduce the incidence of superinfection.

关 键 词：颅脑伤 下呼吸道 双重感染 防治 

分 类 号：R651.15[医药卫生—外科学]