重症监护室脑血管病并发感染相关因素分析

目的探讨重症监护室脑血管病变患者发生感染的相关危险因素，探讨相应的防治措施。方法采用前瞻性加回顾性收集上海市东方医院重症监护室收治脑血管意外病例877例，以入院后发生的感染为准，分析重症监护室脑血管意外患者感染的危险因素。结果877例重症监护室脑血管意外患者住院期间发生感染427例（48．7％），其中肺部感染360例（41．0％）、泌尿系统感染25例（2．9％）、肺部合并泌尿系统感染12例（1．4％）、其他感染（颅内、深静脉、其他不明原因感染）30例（3．4％）。结论重症监护室脑血管意外感染发生除与宿主对感染的易感性包括性别、原发疾病严重程度和免疫防御功能、脑血管意外种类、基础疾病、住院时间有关外，环境因素、生活习惯、抗生素不合理应用、医疗侵入性操作等外，等均与感染发生有关。

Risk factors of infection for patients with cerebrovascular accidence in intensive care unit

Objective To investigate the risk factors of infection for patients with cerebrovascular accidence in intensive care unit （ICU）. Methods Total 877 patients with cerebral vascular accident admitted in ICU, Shanghai East Hospital were enrolled in the study. The clinical data were retrospectively reviewed and the risk factors of infection were analyzed. Results Infection was developed in 427 out of 877 patients （48.7%） during ICU stay, including pulmonary infection in 360 cases（41.0% ） , urinary tract infection in 25 （2.9%） , combined pulmonary and urinary tract infection in 12 （ 1.4 % ）, other infections （ intracranial, deep vein infection and unknown site infection） in 30 cases （ 3.4% ）. Conclusion The risk factors of ICU cerebrovascular accident patients include gender, underlying diseases and disease severity, immune function, types of cerebral vascular accident, length of hospital stay, unreasonable antibiotics use and medical procedures.