ICU脑出血患者肺部感染的危险因素分析

目的探讨ICU脑出血患者肺部感染危险因素。方法选择135例ICU脑出血患者，统计年龄、既往吸烟史、住院时间、呼吸机使用时间以及开放气道方法与肺部感染的关系。结果年龄≥60岁、既往吸烟史、住院时间≥14d、合并慢性阻塞性肺疾病（COPD）及昏迷患者出现肺部感染的比率显著升高（P〈0．05）。呼吸机使用时间≥3d以及通过气管插管或气管切开方式开放气道的患者发生肺部感染的比率显著升高（P〈0．05）；多因素分析发现，年龄≥60岁、有吸烟史、住院时间≥14d、合并COPD、昏迷、使用呼吸机时间≥3d及气管插管或气管切开均与肺部感染有关。结论患者年龄超过60岁，既往有吸烟史以及住院时间超过14d，住院期间通过有创方式开放气道并使用呼吸机超过3d是发生肺部感染的高危因素。

Related factors of pulmonary infection and preventive measures with intracerebral hemorrhage in ICU

Objective To investigate the risk factors of lung infection in ICU with intracerebral hemorrhage. Methods 135 cases in ICU with cerebral hemorrhage were selected, the relation between pulmonary infection and age, previous smoking history, length of stay, ventilation time, airway opening were analyzed. Results The pulmonary infection rate in patients with age ≥60 years, smoking history, hospitalization time ≥14 d, combined COPD and coma were higher （P〈0.05）. The incidence rate of lung infection in patients with ventilation time ≥ 3 days as well as endotracheal intubation or tracheostomy was significantly higher （P〈0.05）.Multivariate analysis found that age ≥ 60 years, smoking history, length of stay ≥14 days, combined COPD and coma, ventilator time ≥3 d and endotracheal intubation or traeheostomy were associated with lung infection. Conclusion The age older than 60 years, previous history of smoking, hospitalization exceeding 14 days, mechanical ventilator over 3 days are the risk factors of pulmonary infection.