103例重型颅脑损伤患者医院感染临床分析

目的探讨重型颅脑损伤并发医院感染的临床规律。方法对我科2009年1月～2011年1月收治的重型颅脑损伤并发医院感染103例作回顾性总结,对格拉斯哥昏迷评分（GCS）与感染的关系、感染部位和易感因素及病原学检查等行统计学分析。结果院内感染发病率为23.78%。感染部位依次是肺部49.51%、泌尿道20.38%、消化道14.56%、颅内感染8.74%、血液系统感染4.85%;医院感染中革兰氏阴性菌占69.78%,革兰氏阳性菌占30.22%。危险因素为病情严重程度、侵袭性医疗操作（如机械通气、中心静脉置管、保留导尿等）和药物治疗。结论尽量减少或避免医源性危险因素的产生和损伤,能有效地预防和控制重型颅脑损伤院内感染。

Clinical analysis of 103 patients with severe cranial trauma complicated with noscomial infections

Objective To explore the clinical features of patients with severe cranial trauma complicated with nosocomial infections.Methods Retrospective studies were conducted on the 103 cases of severe cranial trauma complicated with noscomial infections from Jan.2009 to Jan.2011,statistical analysis was made in the relation between GCS and infection,infection site,predisposing factor and etiological examination.Results The rate of nosocomial infection was 23.78%.Infection mainly occurred in lung(49.51%),urinary tract(20.38%),digestive tract(14.56%),intracranial part(8.74%) and hematological system(4.85%).In the nosocomial infection,the main pathogens were Gram negative bacteria(69.78%).Gram positive bacteria accounted for 30.22%.The iatrogenic risk factors were patients’ condition,invasive medical operation(mechanical ventilation,central venous catheterization,use of urethral catheters,and so on) and drug treatment.Conclusion We should manage to reduce or avoid the damage of the iatrogenic risk factors,so as to effectively prevent and control nosocomial infections in the patients with severe cranial trauma.