创伤患者感染鲍曼不动杆菌危险因素及其死亡率的调查研究

目的探讨创伤患者感染鲍曼不动杆菌的危险因素。方法收集该院2006～2009年的创伤患者330例,采用损伤严重程度计分(ISS)及格拉斯哥昏迷评分表(GCS)进行回顾性分析。结果 330例创伤患者中感染鲍曼不动杆菌36例。鲍曼不动杆菌感染的危险因素单因素分析显示较高的ISS评分(P=0.02)、较低的入院时GSC评分(P=0.03)、较长的入住重症监护室(ICU)时间(P=0.000 01)、机械通气时间(P=0.000 01)、内固定术(P=0.003)等,以及多因素分析显示机械通气时间与内固定术是感染鲍曼不动杆菌的独立危险因素,感染鲍曼不动杆菌有较高的病死率,病死率高低与ISS及GCS评分有关。结论延长机械通气时间与内固定术是导致严重创伤患者鲍曼不动杆菌感染的主要危险因素,但感染鲍曼不动杆菌并不影响患者病死率。

A survey of risk factors of Acinetobacter baumannii infection in trauma patients and their mortality

Objective To explore the risk factors of Acinetobacter baumannii infection in trauma patients.Methods 330 trauma patients admitted to this hospital from 2006 to 2009 were selected.Injury severity score(ISS) and Glasgow coma scale(GCS) were employed to conduct retrospective analysis.Results Among 330 trauma patients,36 were infected with Acinetobacter baumannii.Univariate analysis of the risk factors of Acinetobacter baumannii infection demonstrated significantly higher ISS score(P=0.02),lower GSC score on admission(P=0.03),longer duration of intensive care unit(ICU) stay(P=0.000 01) and mechanical ventilation(P=0.000 01),internal fixation(P=0.003).Multivariate analysis showed the duration of mechanical ventilation and internal fixation were independent risk factors of Acinetobacter baumannii infection.Patients with Acinetbobacter baumannii possessed high mortality rate which level was related to the score of ISS and GCS.Conclusion Prolong the duration of mechanical ventilation and internal fixation were the major risk factors of severe trauma patients infected with Acinetobacter baumannii,however,Acinetobacter baumannii infection does not affect the mortality of patients.