【摘要】：目的分析骨科創(chuàng)傷患者醫(yī)院獲得性肺炎(HAP)的危險因素,為制定預(yù)防控制措施提供依據(jù)。方法回顧性調(diào)查2011年6月—2015年5月某院骨科病房創(chuàng)傷患者發(fā)生HAP的情況,并采用單因素和多因素logistic回歸分析其危險因素。結(jié)果共調(diào)查骨科創(chuàng)傷患者2 578例,發(fā)生HAP92例,HAP發(fā)病率3.57%。92例HAP患者共檢出病原菌107株,主要為肺炎克雷伯菌(22株,占20.56%)、大腸埃希菌(14株,占13.08%)、鮑曼不動桿菌(13株,占12.15%)等。住院日數(shù)≥15 d、吸煙史≥3年、臥床≥7 d、伴有基礎(chǔ)疾病、合并癥、留置導(dǎo)尿管≥7 d、采用手術(shù)治療、采用機械通氣、入住ICU、開放性損傷、血糖≥11 mmol/L、血漿清蛋白30 g/L、血紅蛋白濃度90 g/L和糖皮質(zhì)激素使用≥4 d等14個因素均是骨科創(chuàng)傷患者發(fā)生HAP的危險因素(均P0.05)。多因素logistic回歸分析顯示,吸煙、臥床、手術(shù)治療、機械通氣、使用糖皮質(zhì)激素和貧血6個因素為骨科創(chuàng)傷患者發(fā)生HAP的獨立危險因素。結(jié)論骨科創(chuàng)傷患者HAP與多種因素有關(guān),其中以手術(shù)治療、機械通氣、糖皮質(zhì)激素使用、長期吸煙、臥床和貧血等6個因素為主。
[Abstract]:Objective to analyze the risk factors of (HAP) in orthopedic trauma patients with hospital-acquired pneumonia, and to provide evidence for prevention and control measures. Methods the incidence of HAP in trauma patients in orthopedic ward from June 2011 to May 2015 was investigated retrospectively. the risk factors were analyzed by univariate and multivariate logistic regression analysis. Results A total of 2578 patients with orthopaedic trauma occurred HAP. The incidence of HAP was 3.57%. A total of 107 strains of pathogenic bacteria were detected in 92 patients with HAP, mainly Klebsiella pneumoniae (22 strains, 20.56%), Escherichia coli (14 strains, 13.08%) and Acinetobacter baumannii (13 strains, 12.15%). Hospital stay 鈮，

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