后颅窝术后颅内感染多重耐药鲍曼不动杆菌的临床分析及护理体会  

Clinical analysis and nursing experience of multi-drug resistant Acinetobacter baumannii in intracranial infection after posterior fossa craniotomy

作　　者：朱琳[1] 杨兴菊[1] 亓爱红[1] 刘振瑞 潘强[2] 宋纯玉[2] 刁兴涛[2] 刘聪聪 

机构地区：[1]泰山医学院附属莱芜医院ICU,莱芜271199 [2]泰山医学院附属莱芜医院神经外科,莱芜271199 [3]山东省立医院ICU,济南250000

出　　处：《中国实用神经疾病杂志》2017年第9期26-29,共4页Chinese Journal of Practical Nervous Diseases

基　　金：泰山医学院附属莱芜医院科研资助项目(YYLX2013016,YYLX2013019,YYLX2014011)

摘　　要：目的介绍后颅窝手术后并发颅内感染多重耐药鲍曼不动杆菌感染特点及相关治疗及护理体会,为后期治疗、护理提供临床经验。方法回顾性分析2012-01—2014-07我院4例后颅窝术后并发的颅内感染多重耐药鲍曼不动杆菌患者临床资料、治疗及护理经验。结果后颅窝术后颅内感染多重耐药鲍曼不动杆菌4例患者经过综合治疗护理后全部痊愈,治愈率100%。结论后颅窝术后容易并发颅内感染,预防、护理是关键。一旦发生颅内感染多重耐药鲍曼不动杆菌,应早期采取腰大池持续外引流基础上,脑脊液细菌分离培养进行菌株鉴定和药敏试验,静滴、鞘内注射敏感抗生素,并给予激素、营养支持等治疗措施,同时强调医务人员手卫生、感染患者隔离、加强微生物检测、彻底环境消毒、采取相应护理措施,加强医院感染管理力度等能提高治愈率。Objective To introduce the clinical features and the related nursing experience of multi-drug resistant Acinetobacter baumannii（MDR-AB） in intraeranial infection after posterior fossa eraniotomy, in order to provide clinical experiences for subsequent treatment and nursing. Methods We retrospectively analyzed the clinical data of four cases with MDR-AB in intracranial infection complicated with posterior fossa craniotomy from January 2012 to July 2014. Then we summarized the therapeutic and nursing experiences. Results All patients completely cured after comprehensive treatment and related nursing interventions performed. The curative rate was 100%. Conclusion Because posterior fossa surgery may he easily complicated with intracranial infection,preventions and nursing cares are the key. Once MDR-AB in intracranial infection occurred,after isolating and culturing bacteria strains of CSF and then performing strain identification and susceptibility test, we should carry out intrathecal and intrave nous antibiotics sensitive to the causative organism as well as hormone, nutritional support and other therapeutic measures based on continuous drainage of cerebrospinal fluid（CSF）from lumber pool. Simultaneously,it is universally important that underlining hand hygiene of medical staff,isolating infectious patients, strengthening microbiological detection, thoroughly disinfecting environ ment,adopting related nursing measures and enhancing infection management can improve curative rate.

关 键 词：后颅窝手术 鲍曼不动杆菌 多重耐药 防治措施 护理 

分 类 号：R651.11[医药卫生—外科学]