重度颅脑损伤气管切开并发肺部感染的临床研究

目的探讨救治重度颅脑损伤并发肺部感染患者的有效方法。方法对本院脑外科及ICU2003年2月-2006年2月收治的82例重度颅脑损伤并发肺部感染的患者做回顾性分析。结果肺部感染的死亡率78．1％，病死率显著高于无肺部感染者P〈0．05。共培养出328株病菌，其中革兰氏阴性杆菌株202，革兰氏阳性球菌46株，真菌80株。结论救治此种合并伤患者，尽早气管切开并行痰培养、根据药敏用药，对降低伤残与死亡率有十分重要的意义。

Study of Severe Traumatic Brain Injury with infection of lung after tracheotomy

Objective To explore the way for emergency management of patients with infection of lung after tracheotomy. Meth. ods Clinical data of 82 cases with severe traumatic brain injury with infection of lung after tracheotomy in our hospital were analyzed ret- rospectively. The patients were admitted to the department of brain surgery and ICU between February 2003 and February 2006. Results Incidence rate of infection of lung was 78. 1%. The death rate of infected patients was significantly higher than non-infected patients（ P 〈 0. 05 ）. 328 strains of parhogenic bacteria were found. 202 were gram-negative, and 46 were gram-positive. 80 were fungi. Conclusion With regard to there cases, early sputum culture and the proper selection of antibiotics based on antinticrobial susceptibility testing are very important to decrease the morbidity and mortality rates.