神经外科行机械通气动脉瘤破裂患者肺部多重耐药菌感染现状及相关因素分析  

Analysis of risk factors and current situation for pulmonary multidrug-resistant bacterial infection in neurosurgery reptured aneurysm patients with mechanical ventilation

作　　者：任佳仪 曲虹 蒋金 REN Jia-yi;QU Hong;JIANG Jin(Department of Neurosurgery,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]中国医科大学,辽宁沈阳110122 [2]北部战区总医院神经外科,辽宁沈阳110016

出　　处：《创伤与急危重病医学》2022年第5期324-327,共4页Trauma and Critical Care Medicine

摘　　要：目的 探讨神经外科行机械通气的动脉瘤破裂患者肺部感染多重耐药菌(MDRO)的现状及相关因素分析。方法 选取北部战区总医院2020年1月至2021年12月神经外科收治的使用呼吸机进行机械通气的110例动脉瘤破裂患者,收集临床资料,包括痰培养及药敏实验结果,总结和分析患者感染MDRO的现状及相关因素。结果 进行机械通气的110例动脉瘤破裂患者肺部感染MDRO的发生率为23.6%(26/110)。26例患者送检的痰标本中共检出MDRO 31株,均为革兰阴性杆菌。多因素分析结果显示,气管切开、上机前白蛋白水平及ICU住院时间是神经外科行机械通气的动脉瘤破裂患者肺部感染多重耐药菌的主要影响因素。结论 气管切开、上机前白蛋白水平及ICU住院时间均为神经外科行机械通气的动脉瘤破裂患者肺部感染多重耐药菌的主要影响因素,应针对上述影响因素制定合理有效的干预措施,降低MDRO感染发生率,改善患者预后。Objective To investigate the status and related factors of pulmonary infection with multidrug-resistant bacteria(MDRO) in patients with ruptured aneurysm undergoing mechanical ventilation in neurosurgery.Methods A total of 110 patients with ruptured aneurysm who received mechanical ventilation with a ventilator in the NeUrosurgery Department from January 2020 to December 2021 were selected. Clinical data, including sputum culture and drug sensitivity test results, were collected, and the current situation and related factors of MDRO infection were summarized and analyzed.Results The incidence of pulmonary infection with MDRO was 23.6%(26/110) in 110 patients with ruptured aneurysm who underwent mechanical ventilation.A total of 31 strains of MDRO were found in sputum samples from 26 patients, all of which were Gram-negative bacilli.Multivariate analysis showed that tracheotomy, albumin level before mechanical ventilation, and length of ICU stay were the main influencing factors of pulmonary infection with multidrug-resistant bacteria in patients with ruptured aneurysm undergoing mechanical ventilation in neurosurgery.Conclusion Tracheotomy, albumin level before mechanical ventilation, and length of ICU stay are the main influencing factors of pulmonary infection with multidrug-resistant bacteria in patients with ruptured aneurysm undergoing mechanical ventilation in neurosurgery. Reasonable and effective intervention measures should be formulated to reduce the incidence of MDRO infection and improve the prognosis of patients.

关 键 词：多重耐药 相关因素 动脉瘤破裂 机械通气 

分 类 号：R651[医药卫生—外科学]