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目的探讨重型颅脑损伤患者院内感染的临床特点。方法回顾性查阅出院归档病案,进行医院感染发生例次数、医院感染率、感染部位、致病菌种类统计,观察院内感染对预后的影响,以及医院感染病例的潜在易感因素统计。结果 142例患者发生院内感染60例:肺部感染31例,泌尿系感染19例,消化系感染8例,手术切口感染2例;培养138例次,检出病原微生物89株:G-杆菌42株,G+菌28株,真菌19株;年龄、合并其他疾病、昏迷、住院时间长、肾上腺皮质激素应用时间长、进行侵入性操作、预防应用抗生素是发生医院感染的危险因素;院内感染组死亡占32.33%高于非感染组的12.20%。结论重型颅脑损伤患者合并院内感染发生率较高,可增加病死率;应加强预防医院感染管理,减少医院感染的发生。
Objective To investigate the clinical features of nosocomial infections in patients with severe craniocerebral injury. Methods The hospital records were reviewed retrospectively. The incidences of nosocomial infections, nosocomial infection rates, infection sites and pathogenic bacteria were retrospectively analyzed. The impact of nosocomial infection on prognosis and the potential risk factors of nosocomial infections were analyzed. Results There were 60 cases of nosocomial infection in 142 patients: 31 cases of lung infection, 19 cases of urinary tract infection, 8 cases of digestive tract infection and 2 cases of surgical incision infection. In 138 cases, 89 strains of pathogenic microorganisms were detected: G- 28 strains of G + bacteria and 19 strains of fungi. Age, combined with other diseases, coma, long hospital stay, adrenal corticosteroids for a long time, invasive operation, prevention and application of antibiotics is a risk factor for nosocomial infection; nosocomial infection group died Accounting for 32.33% higher than non-infected group 12.20%. Conclusions Patients with severe craniocerebral injury have a higher incidence of nosocomial infections and may increase the mortality rate. Prevention of nosocomial infection should be strengthened to reduce the incidence of nosocomial infections.