重型颅脑创伤气管切开患者下呼吸道感染的治疗研究  

Study on treatment of lower respiratory tract infections after tracheotomy in patients with severe craniocerebral trauma

作　　者：甘晓[1] 刘向业[1] 张东波[2] 

机构地区：[1]南阳市中心医院创伤外科,河南南阳473009 [2]南阳市中心医院神经外科,河南南阳473009

出　　处：《中华医院感染学杂志》2015年第7期1599-1600,1612,共3页Chinese Journal of Nosocomiology

基　　金：河南省科技厅重点基金项目(XP2608257)

摘　　要：目的探讨重型颅脑创伤气管切开患者下呼吸道感染的治疗,为临床预防及治疗重型颅脑创伤气管切开患者感染提供重要参考。方法回顾性分析2009年1月-2013年11月229例重型颅脑创伤气管切开患者临床资料及下呼吸道分泌物培养结果,对感染患者应用头孢哌酮、头孢呋辛、头孢他啶等头孢菌素联合使用喹诺酮类药物或大环内酯类抗菌药物等进行治疗,并进行疗效评定,数据采用SPSS 17.0软件进行统计分析。结果 229例气管切开患者有180例发生下呼吸道感染,感染率为78.6%;共培养出病原菌220株,以革兰阴性菌为主,162株占73.7%;经过治疗后显效82例、有效48例,总有效率为72.2%。结论重型颅脑创伤气管切开患者极易并发下呼吸道感染且发病率较高,应引起临床足够重视,采取相关措施预防或者减少下呼吸道感染的发生。OBJECTIVE To study the treatment of lower respiratory tract infections after tracheotomy in patients with severe craniocerebral trauma,so as to provide reference for clinical prevention and treatment of infections after tracheotomy in patients with severe craniocerebral trauma.METHODS A retrospective analysis was conducted on clinical data and culture results of lower respiratory tract secretions of 229 cases of tracheotomy for severe craniocerebral trauma during Jan.2009 to Nov.2013 in our hospital.Patients were treated with cephalosporins（cefoperazone,cefuroxime,ceftazidime,etc.）combined with quinolones or macrolides and were evaluated for clinical efficacy.The software SPSS 17.0was used for statistical analysis of data.RESULTS Totally 180 out of229cases of patients undergoing tracheotomy had lower respiratory tract infections,with the infection rate of78.6%.A total of 220 strains of pathogenic bacteria were cultured,mainly including gram-negative bacteria of 162strains（73.7%）.There were 82 improved cases and 48 effective cases with the total efficacy of 72.2%.CONCLUSIONPatients with severe craniocerebral trauma undergoing tracheotomy are easily complicated with lower respiratory tract infections and the incidence rate of infection is high,which should raise sufficient clinical attention,relevant measures should be taken to prevent or reduce the occurrence of lower respiratory tract infections.

关 键 词：重型颅脑创伤 气管切开 下呼吸道感染 

分 类 号：R619.3[医药卫生—外科学]