本文選題：顱腦外傷　切入點(diǎn)：下呼吸道感染　出處：《中華醫(yī)院感染學(xué)雜志》2017年21期 　論文類型：期刊論文

【摘要】：目的探討和分析重型顱腦外傷患者術(shù)后下呼吸道感染相關(guān)因素及病原菌分布和耐藥情況。方法選取2013年1月-2015年12月醫(yī)院所收治的696例重型顱腦外傷手術(shù)患者作為研究對(duì)象,并分別對(duì)重型顱腦外傷手術(shù)患者的性別、年齡、GCS評(píng)分、基礎(chǔ)疾病、創(chuàng)傷性操作、預(yù)防應(yīng)用抗菌藥物、營(yíng)養(yǎng)供給、住院時(shí)間等相關(guān)因素以及病原菌分布和耐藥情況進(jìn)行分析。結(jié)果本研究696例重型顱腦外傷手術(shù)患者中發(fā)生下呼吸道感染75例,感染率為10.78%;年齡60歲,GCS評(píng)分≤5分,有基礎(chǔ)疾病,侵入性操作,預(yù)防應(yīng)用抗菌藥物,營(yíng)養(yǎng)供給不足,住院時(shí)間14d是重型顱腦外傷患者術(shù)后下呼吸道感染的危險(xiǎn)因素,差異均具有統(tǒng)計(jì)學(xué)意義(P0.05);經(jīng)Logistic回歸分析,GCS評(píng)分、侵入性操作以及預(yù)防應(yīng)用抗菌藥物是重型顱腦外傷患者術(shù)后下呼吸道感染的獨(dú)立危險(xiǎn)因素(P0.05);75例感染患者共檢出病原菌92株,其中革蘭陰性菌占71.74%,革蘭陽(yáng)性菌占18.48%,真菌占9.78%;革蘭陰性菌對(duì)美洛西林、頭孢曲松、環(huán)丙沙星均表現(xiàn)出較高的耐藥性,其耐藥率均50%,對(duì)亞胺培南的耐藥性較低,革蘭陽(yáng)性菌對(duì)青霉素、阿奇霉素、頭孢唑林、苯唑西林均表現(xiàn)出較高的耐藥性,其耐藥率均50%,對(duì)萬(wàn)古霉素耐藥性較低。結(jié)論重型顱腦外傷患者術(shù)后下呼吸道感染與GCS評(píng)分,侵入性操作,預(yù)防應(yīng)用抗菌藥物等因素相關(guān),病原菌分布以革蘭陰性菌為主,應(yīng)結(jié)合其耐藥情況及時(shí)合理應(yīng)用抗菌藥物。
[Abstract]:Objective to investigate and analyze the related factors of lower respiratory tract infection, the distribution of pathogenic bacteria and drug resistance in patients with severe craniocerebral trauma after operation. Methods 696 patients with severe craniocerebral trauma were selected from January 2013 to December 2015. Gender, age and GCS scores, basic diseases, traumatic operations, prophylactic use of antimicrobial agents, nutrition supply were evaluated in patients with severe craniocerebral trauma. Results there were 75 cases of lower respiratory tract infection in 696 patients with severe craniocerebral trauma, the infection rate was 10.78%, and the GCS score of 60 years old was 鈮，

本文編號(hào)：1630537