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目的通过对近二年重度颅脑损伤患者医院获得性肺炎(HAP)的危险因素及病原学特征进行分析,针对主要的感染途径,制订预防的主要措施,旨在进一步降低重度颅脑损伤患者HAP的发生率。方法将2007年1月—2009年12月收住我科、住院时间>48h、发生HAP的73例重度颅脑损伤患者进行回顾性分析,寻找感染相关因素及预防措施。结果昏迷、卧床、气管插管或气管切开、机械呼吸、胃内容物反流、误吸等为重度颅脑损伤患者并发HAP的危险因素。最常见的病原菌为革兰阴性菌,占63.12%。前三位致病菌依次为铜绿假单胞菌、鲍曼不动杆菌和金黄色葡萄球菌。结论加强护理管理、认真做好呼吸道管理、减少侵入性诊疗手段带来的感染机会、加强口腔护理等护理措施,可望有效降低HAP的发生率。
Objective To analyze the risk factors and etiological characteristics of hospital acquired pneumonia (HAP) in patients with severe craniocerebral injury in the past two years and to establish the main preventive measures aimed at the main routes of infection in order to further reduce the HAP in patients with severe craniocerebral injury The incidence of. Methods A retrospective analysis was performed on 73 cases of severe craniocerebral injury who were admitted to our department from January 2007 to December 2009 and were hospitalized for> 48 hours. HAP was performed to find out the related factors and preventive measures. Results Coma, bed rest, endotracheal intubation or tracheotomy, mechanical respiration, reflux of gastric contents, aspiration and other risk factors for HAP in patients with severe craniocerebral injury. The most common pathogen is Gram-negative bacteria, accounting for 63.12%. The first three pathogenic bacteria followed by Pseudomonas aeruginosa, Acinetobacter baumannii and Staphylococcus aureus. Conclusions It is expected to reduce the incidence of HAP effectively by strengthening nursing management, conscientiously doing respiratory management, reducing the chances of infection caused by invasive diagnosis and treatment and strengthening nursing interventions such as oral care.