重症颅脑外伤在ICU出现肺部感染29例临床分析

目的:分析在我院ICU重症颅脑外伤患者肺部感染的菌群分布、发生率等因素,探讨防范与治疗措施。方法:对ICU 126例重症颅脑患者进行医院感染调查,计算肺部感染的发病率并进行菌群分析。结果:出现肺部感染29例,感染率为23.0%。由患者痰标本经细菌学检验分离出致病菌37株,阳性例数较多的为革兰阴性菌,其敏感的抗菌药物为亚胺培南/西司他丁、头孢呱酮/舒巴坦、阿米卡星;对耐亚胺培南/西司他丁革兰阳性球菌对万古霉素、复方新诺明敏感;真菌感染对氟康唑耐药增多,对斯皮仁诺仍敏感。结论:本组病例肺部感染有多重耐药、多重感染的特点,故应合理先用抗菌药物,建立严格的保护性隔离措施,积极治疗脑外伤促进早日清醒。

Clinical Analysis of 29 Serious Craniocerebral Trauma cases Accompanying Pulmonary Infection in ICU

Objective: Investigating flora distribution and incidience of serious craniocerebral trauma cases accompanying pulmonary infection in ICU to formulate preventive and therapeutic use.Methods: we studied hospital infection in 126 cases of serious craniocerebral trauma to count flora distribution and pulmonary infection incidience.Results: 29 cases occurred pulmonary infection in our study.The incidence rate was 23.0%.In the clinical sputum,37 bacteria strains were isolated,The Gram-positive bacilli were more than the Gram-negative bacilli.The effective antibiotics included imipenem/cilastatin sodium,cefoperazone/sulbactam,amikacin,et al.Vancomycin and SMZ-TPM were also effective to the resistance-imipenem/cilastatin sodium Gram-positive bacilli.Fungal infection was more resistant to fluconazole,but was sensitive to itraconazole.Conclusions: There are multi-drug resistance and multi-infection in the cases of our study.So we must use antibiotics properly,establish the strict protection and treat brain trauma properly for the recovery.