颅内动脉瘤破裂蛛网膜下腔出血介入术后肺部感染危险因素及病原菌分布  

Risk factors and pathogen distribution of postoperative pulmonary infection after interventional treatment for intracranial aneurysmal subarachnoid hemorrhage

作　　者：吕高鹏 邓建中[1] LÜGaopeng;DENG Jianzhong(Department of Neurology,Anyang District Hospital of Puyang City,Puyang 455000,China)

机构地区：[1]濮阳市安阳地区医院神经内科,河南濮阳455000

出　　处：《黑龙江医药科学》2025年第1期99-102,共4页Heilongjiang Medicine and Pharmacy

摘　　要：目的:探究颅内动脉瘤破裂性蛛网膜下腔出血介入术后肺部感染危险因素及病原菌分布,制定早期治疗方案。方法:回顾性选取2020年2月至2023年9月在濮阳市安阳地区医院行介入治疗的152例颅内动脉瘤破裂蛛网膜下腔出血患者,据术后情况分为感染组35例及未感染组117例。统计感染组患者病原菌学特点,比较两组临床资料,危险因素的发现采用Logistic回归分析。结果:手术时间>3 h、吸烟史、年龄大、吞咽功能障碍、合并基础疾病、肺部疾病史、有侵入性操作、Hunt-Hess分级Ⅲ级含以上是介入术后肺部感染的危险因素(P<0.05)。Logistic回归分析显示手术时间>3 h、吞咽功能障碍、有侵入性操作、Hunt-Hess分级Ⅲ级含以上是介入栓塞术后肺部感染的独立危险因素(P<0.05)。从35例肺部感染患者共分离出48株病原菌,其中革兰阳性菌6株占12.5%,革兰阴性菌42株占87.5%。结论:蛛网膜下腔出血介入术后发生肺部感染的病原菌以革兰阴性菌为主,与手术时间>3 h、吸烟史、年龄大、吞咽功能障碍、有侵入性操作等因素有关,根据以上给予针对性干预措施,以降低术后肺部感染风险。Objective:To investigate the risk factors and pathogen distribution of postoperative pulmonary infection after interventional treatment for intracranial aneurysmal subarachnoid hemorrhage,and to develop early treatment strategies.Methods:A retrospective analysis was conducted on 152 patients with intracranial aneurysmal subarachnoid hemorrhage who underwent interventional treatment at Anyang District Hospital of Puyang City from February 2020 to September 2023.The patients were divided into infection group(35 cases)and non-infection group(117 cases)based on their postoperative conditions.The pathogen characteristics of the infection group were analyzed,and clinical data between the two groups were compared.Logistic regression analysis was used to identify risk factors.Results:The risk factors for postoperative pulmonary infection after interventional treatment included surgery duration exceeding 3 hours,smoking history,advanced age,dysphagia,underlying diseases,history of lung disease,invasive procedures and Hunt-Hess grade III or above(P<0.05).Logistic regression analysis revealed that surgery duration exceeding 3 hours,dysphagia,invasive procedures and Hunt-Hess grade III or above were independent risk factors for postoperative pulmonary infection after interventional embolization(P<0.05).A total of 48 pathogens were isolated from 35 patients with pulmonary infection,including 6 Gram-positive bacteria 12.5%and 42 Gram-negative bacteria 87.5%.Conclusion:The primary pathogens responsible for postoperative pulmonary infection following interventional treatment for subarachnoid hemorrhage are Gram-negative bacteria,which are associated with various factors including surgery duration exceeding 3 hours,smoking history,advanced age,dysphagiaand invasive procedures.Targeted interventions aimed at factors can help reduce the risk of postoperative pulmonary infection.

关 键 词：颅内动脉瘤 蛛网膜下腔出血 介入 肺部感染 病原菌 危险因素 

分 类 号：R739.41[医药卫生—肿瘤]