重型颅脑外伤行气管切开并发院内获得性肺炎临床分析

目的探讨重型颅脑外伤行气管切开后院内获得性肺炎的相关因素.方法采用回顾性方法对49例重型颅脑外伤行气管切开术并发院内获得性肺炎(HAP)患者的临床资料进行分析.结果伤后24 h内气管切开组HAP感染率显著低寸:伤后24 h后气管切开组(P＜0.01);伤后24 h内气管切开组感染控制率显著高于伤后24 h后气管切开组(P＜0.05);感染控制时间也显著短于伤后24 h后气管切开组(P＜0.01);痰培养结果以肺炎克雷伯杆菌、铜绿假单胞菌及大肠埃希菌为主;其次为革兰阳性球菌以金黄色葡萄球菌及表皮葡萄球菌为主.结论重型颅脑外伤昏迷患者应及早行气管切开,合理选用抗菌药物,加强全身支持治疗,提高机体抵抗力,能有效地救治重型颅脑外伤并发HAP.

Clinical analysis of hospital acquired pneumonia in patients with severe crancal trauma after tracheotomy

Objective: To discuss the relevant factors of hospital acquired pneumonia in patients with severe cranical trauma after tracheotomy.Methods:The clinical information of 49 patients suffering from HAP with severe cranical trauma after tracheotomy were analyzed by retrospective study.Results:The infection rate of trial group(severe cranical trauma after tracheotomy in 24 hours) was obviously lower than that of contrast group(tracheotomy after 24 hours)( P <0.01),contrast rate was higher( P <0.05),and control time was shorter( P <0.01).Most of the sputum bacteria cultuers were K.pneumoiae, P.aeruginosa, E.coli, secondary were Glare positive coccus,such as stahylococcus aureus and staphylococcus epidermidis and so on.Conclusions:Tracheotomy should be applied to the carotic patients as soon as possible.Choosing antibacterial in reason,reinforcing therapy of systemic sustainment and improving immunity of organism can effectively cure hospital acquired pneumonia in patients with severe cranical trauma after tracheotomy.