脑外伤感染病原菌及治疗后巴士指数和SAS及SDS评分分析  

Pathogens isolated from brain trauma patients with infection and bus index, SAS and SDS after treatment

作　　者：陈燕娣[1] 蒋晓春 黄婷婷 王伟[1] 蔡凤妹 CHEN Yan-di;JIANG Xiao-chun;HUANG Ting-ting;WANG Wei;CAI Feng-mei(Zhejiang Provincial Tongde Hospital, Hangzhou , Zhejiang 310012, China)

机构地区：[1]浙江省立同德医院精神科

出　　处：《中华医院感染学杂志》2019年第13期1989-1992,共4页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81072618)

摘　　要：目的探讨巴士指数联合焦虑自评量表(SAS)、抑郁自评量表(SDS)评分评价脑外伤所致精神障碍患者心理状态的效果和医院感染特点分析。方法回顾性分析2015年8月-2017年6月医院收治的90例脑外伤患者治疗过程,治疗前后使用巴士指数量表联合SAS、SDS评估所有患者精神状态,探讨巴士指数联合SAS、SDS评分的应用价值,分析术后获得性感染的危险因素及病原菌情况。结果巴士指数量表评分结果:治疗后明显高于治疗前(P<0.05);SAS、SDS量表评分结果:治疗后显著低于治疗前(P<0.05);35例术后获得性感染患者共检出病原菌株58株,其中革兰阳性菌占比最高,分析革兰阳性菌是引起脑外伤患者术后感染的主要病原菌;药敏试验结果显示,金黄色葡萄球菌对万古霉素敏感度最高;常见革兰阴性菌对头孢类抗菌药物敏感度最高。结论引起脑外伤患者术后获得性感染的危险因素多且复杂,及早进行病原菌检测和药敏试验,选用针对性的抗菌药物治疗,提升治疗效果。OBJECTIVE To explore the effect of bus index combined with self-rating anxiety scale(SAS) and self-rating depression scale(SDS) on evaluation of psychological state of patients with mental disorders and analyze the characteristics of nosocomial infection. METHODS A total of 90 patients with brain trauma who were treated in the hospital from Aug 2015 to Jun 2017 were enrolled in the study, the treatment processes were retrospectively analyzed, the psychological states of all the patients were evaluated before and after the treatment with the use of bus index combined with SAS and SDS, the value of the bus index combined with SAS and SDS was explored, and the risk factors for postoperative acquired infection and distribution of pathogens were observed. RESULTS The score of bus index scale was significantly higher after the treatment than before the treatment( P<0.05). The scores of SAS and SDS were significantly lower after the treatment than before the treatment(P<0.05). Totally 58 strains of pathogens were isolated from 35 patients who had postoperative acquired infection, among which the gram-positive bacteria were dominant. The gram-positive bacteria were the predominant pathogens causing the postoperative infection in the brain trauma patients. The result of drug susceptibility testing showed that the drug susceptibility rate of Staphylococcus aureus to vancomycin was the highest;the drug susceptibility rates of the common species of gram-negative bacteria to cephalosporins were the highest. CONCLUSION There are a variety of risk factors for the postoperative acquired infection in the patients with brain trauma, and it is necessary to identify the pathogens, conduct the drug susceptibility testing in early stage and reasonably use antibiotics so as to raise the curative effect.

关 键 词：巴士指数 SAS SDS 脑外伤致精神障碍 术后感染 

分 类 号：R651.1[医药卫生—外科学]