神经外科危重症患者并发下呼吸道感染及预后的相关因素分析

目的探讨神经外科危重症患者并发下呼吸道感染及预后的相关因素。方法收集神经外科危重症患者743例并发下呼吸道感染及预后资料，分析相关危险因素。结果73例发生下呼吸道感染，感染发生率为9．83％，经治疗处理死亡18例。年龄、心脏病、糖尿病、慢性肺部疾病、营养状况、侵人性操作、抗菌药物种类、呼吸机使用、住院时间与患者发生下呼吸道感染有关（P〈0．05），其中死亡组和对照组年龄、心脏病、高血压、糖尿病、慢性肺部疾病、营养状况、抗菌药物种类、呼吸机使用、住院时间比较，差异有统计学意义（P〈0．05）。多因素分析，糖尿病、慢性肺部疾病、侵入性操作、抗菌药物种类是神经外科危重症患者并发下呼吸道感染的独立危险因素（P〈0．05），心脏病、糖尿病、慢性肺部疾病、营养状况是神经外科危重症患者并发下呼吸道感染死亡的独立危险因素（P〈0．05）。结论神经外科危重症患者下呼吸道感染发生率较高，合并症、治疗性操作和用药与下呼吸道感染发生密切相关，合并症多和营养状况差的患者预后差，实施有针对性的护理将有助于降低下呼吸道感染发生。

Analysis of the risk factors of neurosurgical critically ill patients with lower respiratory tract infection and prognosis

Objective To investigate the risk factors of neurosurgical critically ill patients with lower respiratory tract infection and prognosis. Methods Neurosurgical critically ill patients 743 cases of lower respiratory tract infection and outcome of concurrent data, analysis of relevant risk factors. Results Seventy-three cases of lower respiratory tract infection, infection rate was 9.83% ,treated 18 patients died after treatment. Age,heart disease,diabetes,chronic lung disease,nutritional status,invasive procedures, antibiotic drug,ventilator use,duration of hospitalization in patients with lower respiratory tract infection （P〈0.05）,in which the death group and the control group of age,heart disease, hypertension, diabetes, chronic lung disease, nutritional status, antibiotic drug, ventilator use, duration of hospitaliza- tion,the difference was statistically significant （P〈0.05）. In multivariate analysis,diabetes ,chronic lung disease, inva- sive procedures, antimicrobial species are critically ill neurosurgical patients with lower respiratory tract infection is an independent risk factor（P〈0.05 ）, heart disease ; diabetes, chronic lung disease, nutritional status neurosurgical critically ill patients were complicated by lower respiratory tract infection independent risk factor for death （P〈0.05）. Conclu- sion Neurosurgical critically ill patients a higher incidence of lower respiratory tract infections,complications, thera- peutic operation and medication with lower respiratory tract infection is closely related to more complications and poor nutritional status of patients with poor prognosis ,the implementation of targeted treatments will help reduce lower respiratory tract infection.