颅脑创伤患者医院感染的危险因素分析

目的探讨颅脑创伤患者医院感染的危险因素。方法回顾性分析1380例颅脑创伤患者的临床资料，将出现医院感染患者作为观察组，无医院感染者作为对照组．对可能影响的因素资料进行单因素分析与Logistic回归分析。结果1380例患者中发生医院感染130例，发生率为9．42％（130／1380）；其中肺部感染最多90例、其次是尿路感染34倒、肠道感染16例。单因素分析结果显示：年龄≥70岁、基础疾病、延髓麻痹、意识障碍、呕吐、存在侵入性操作、夏季、开颅手术、抑酸剂应用时间≥14d、激素应用时间≥7d、住院时间≥14d与医院感染因素有关（OR分别=2．45、1．75、1．93、1．79、2．24、3．24、2．52、2．12、3146、2-52、4．48，P均〈0．05）；非条件Logistic多元回归分析筛出：年龄≥70岁、伴有基础疾病、存在意识障碍、实施侵袭性操作为主要危险因素（OR分别：3．43、3．21、2．96、2183，P均〈0．05）。结论颅脑创伤患者医院感染发生率较高，是多因素综合作用的结果．应针对危险因素采取相应措施避免或减少医院感染的发生。

Analysis on the risk factors of the nosocomial infection in patients with craniocerebral injury

Objective To study the risk factors of the nosocomial infection in patients with craniocerebral injury. Methods Data of 1380 patients with craniocerebral injury were retrospectively studied. The observation group was with nosocomial infections and the control group without nosocomial infections. The possible risk factors were analyzed by single-factor analysis and logistic regression analysis. Results Of 1380 cases ,130 cases （9.42%） got nosocomial infection, among which the most was nosocomial pulmonary infection （ 90 cases）, the second was urinary tract infection （ 34 cases）, the third was intestinal infection （16 cases）. Single-factor analysis indicated： age ≥ 70, underlying diseases, medulla oblongata paralysis, unconsciousness, vomiting, invasive operation, in summer, craniotomy, the time of using acid-suppressing medicine≥ 14d, the time of using glucocorticoid I〉 7d, length of hospital stay ≥ 14d involved in the nosocomial infection （OR=2.45,1.75,1.93,1.79,2.24,3.24,2.52,2.12,3.46,2.52,4.48, P 〈0.05）; Non-conditional logistic regression analysis indicated older, accompanied by underlying diseases, unconsciousness, and invasive operation involved in the nosocomial infection （OR= 3.43,3.21,2.96,2.83, P〈0.05）. Conclusions The higher incidence of nosocomial infection in patients with craniocerebral injury is the result of multiple factors. Corresponding measures should be taken to avoid or reduce the incidence of nosocomial infection.