重型闭合性颅脑损伤开颅术后患者肺部感染因素研究  

Study on pulmonary infection factors in patients with severe closed craniocerebral injury after craniotomy

作　　者：吴亚亭 李爱爱 姚辉 许珏 WU Yating;LI Aiai;YAO Hui;XU Jue(Department of Infection Control,the 904th Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army,Jiangsu Province,Wuxi214044,China)

机构地区：[1]解放军联勤保障部队第九〇四医院感染控制科,江苏无锡214044

出　　处：《中国医药导报》2021年第8期130-132,144,共4页China Medical Herald

基　　金：江苏省医院协会医院管理科研课题(2017YG08)。

摘　　要：目的探讨重型闭合性颅脑损伤开颅术后患者肺部感染的影响因素。方法选取中国人民解放军联勤保障部队第九〇四医院2017年1月—2018年12月收治的160例重型闭合性颅脑损伤开颅术患者资料进行回顾性研究,对发生肺部感染的患者基本资料进行多因素logistic分析。结果160例患者发生60例肺部感染,肺部感染发生率为37.5%。不同年龄、吸烟史、糖尿病病程、术前格拉斯哥昏迷量表(GCS)评分、术中输血量及有无二次手术和气管切开患者肺部感染发生率比较,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,年龄(OR=9.646,95%CI:2.381~39.076)、术前高血糖(OR=7.435,95%CI:1.834~30.134)、术中输血量(OR=3.052,95%CI:1.057~95.622)、二次手术(OR=6.435,95%CI:1.414~29.287)、气管切开(OR=11.769,95%CI:3.642~43.005)、术前GCS评分(OR=4.199,95%CI:2.322~99.613)和吸烟(OR=8.511,95%CI:2.012~35.787)是重型闭合性颅脑损伤开颅术后患者发生肺部感染的影响因素(P<0.05)。结论重型闭合性颅脑损伤开颅术后患者肺部感染因素较多,针对感染危险因素采取综合防控措施,以期预防感染发生。Objective To investigate the influence factors of pulmonary infection in patients with severe closed craniocerebral injury after craniotomy.Methods Data of 160 patients with severe closed craniocerebral injury after craniotomy in the 904th Hospital of Joint Service Support Force of Chinese People’s Liberation Army from January 2017 to December 2018 were retrospectively studied.Multivariate logistic analysis was used to analyze the basic data of patients with pulmonary infection.Results There were 60 cases of pulmonary infection in 160 patients,and the incidence rate of pulmonary infection was 37.5%.There were significant differences In incidence rate of pulmonary infection in different age,smoking history,course of diabetes,GCS score before operation,blood transfusion during operation and secondary operation,tracheotomy or not(P<0.05).Multivariate logistic regression analysis showed that age(OR=9.646,95%CI:2.381-39.076),preoperative hyperglycemia(OR=7.435,95%CI:1.834-30.134),intraoperative blood transfusion(OR=3.052,95%CI:1.057-95.622),secondary operation(OR=6.435,95%CI:1.414-29.287),tracheotomy(OR=11.769,95%CI:3.642-43.005),preoperative GCS score(OR=4.199,95%CI:2.322-99.613),smoking(OR=8.511,95%CI:2.012-35.787)were the influencing factors of pulmonary infection in patients with severe closed craniocerebral injury after craniotomy(P<0.05).Conclusion There are many factors of pulmonary infection in patients with severe closed craniocerebral injury after craniotomy.Comprehensive prevention and control measures should be taken to prevent infection.

关 键 词：重型闭合性颅脑损伤 开颅术 肺部感染 预防措施 

分 类 号：R742[医药卫生—神经病学与精神病学]