影响重型颅脑损伤后呼吸机相关肺炎的因素  

Factors Affecting Ventilator-associated Pneumonia after Severe Head Injury

作　　者：林晓芬 郑谢珠 孙慧红 LIN Xiaofen;ZHENG Xiezhu;SUN Huihong(Department of Neurosurgery,Ningde Hospital of Fujian Medical University,Ningde Fujian 352100,China)

机构地区：[1]福建医科大学附属宁德市医院神经外科,福建宁德352100

出　　处：《中国卫生标准管理》2020年第18期40-42,共3页China Health Standard Management

摘　　要：目的探究与分析影响重型颅脑损伤后发生呼吸机相关肺炎的高危独立因素。方法回顾性分析本院2016年8月—2019年8月收治的67例重型颅脑损伤患者的临床资料,按照是否发生呼吸机相关性肺炎分为观察组(n=18)与对照组(n=49),对比两组性别、年龄、基础合并症、肺外感染、气管切开、Glasgow昏迷评分、进行手术治疗等进行单因素分析,随后对筛选出来的若干变量进行多因素Logistic回归分析。结果经多因素Logistic回归分析可知,合并慢性阻塞性肺疾病、合并糖尿病、肺外感染、气管切开及Glasgow昏迷评分≤9分是影响重型颅脑损伤后发生呼吸机相关肺炎的高危因素。结论合并慢性阻塞性肺疾病、合并糖尿病、肺外感染、气管切开及Glasgow昏迷评分≤9分是影响重型颅脑损伤后发生呼吸机相关肺炎的高危因素,需要引起临床工作者的重视。Objective To explore and analyze the independent highrisk factors of ventilator-associated pneumonia after severe head injury.Methods The clinical data of 67 patients with severe craniocerebral injury treated in our hospital from August 2016 to August 2019 were retrospectively analyzed,and divided into observation group(n=18)and control group(n=49)according to whether ventilator-associated pneumonia occurred.The two groups were compared with gender,age,basic comorbidities,extrapulmonary infection,tracheotomy,Glasgow coma score,surgical treatment and other factors for univariate analysis,and then multivariate Logistic regression analysis for several selected variables.Results Multivariate Logistic analysis showed that combined with chronic obstructive pulmonary disease,diabetes,extrapulmonary infection,presence of tracheotomy,and Glasgow coma score≤9 points were considered to be a high risk of ventilator-associated pneumonia after severe head injury.Conclusion The combination of chronic obstructive pulmonary disease,diabetes,extrapulmonary infection,presence of tracheotomy and Glasgow coma score of≤9 points are considered as high-risk factors that affect the occurrence of ventilator-associated pneumonia after severe head injury,which requires the attention of clinicians.

关 键 词：重型颅脑损伤 呼吸机相关肺炎 基础合并症 GLASGOW昏迷评分 高危因素 回归分析 

分 类 号：R563[医药卫生—呼吸系统]