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目的探讨颅脑损伤合并者医院感染的临床特征。方法回顾性220例颅脑损伤患者的临床资料。结果医院感染发生率36.36%:肺部感染34例,泌尿系26例,消化系13例,其他7例。病原菌培养合并两种及以上病原菌28例次,G-菌72株次,G+菌63株次,真菌44株次,耐药菌株38例次。医院感染组中重残或死亡33.75%高于非感染组的9.29%。年龄大、男性、GCS低、侵入性操作、脱水剂及激素实用时间长、预防抗生素、住院时间长是医院感染的危险因素。结论颅脑损伤患者合并医院感染发生率较高,可增加病死率;应积极治疗原发病、合理应用抗生素、尽可能缩短糖皮质激素及脱水剂应用时间、缩短住院时间。
Objective To investigate the clinical characteristics of nosocomial infection in patients with traumatic brain injury. Methods The clinical data of 220 patients with traumatic brain injury were retrospectively analyzed. Results The incidence of nosocomial infection was 36.36%. There were 34 cases of pulmonary infection, 26 cases of urinary system, 13 cases of digestive system and 7 cases of other cases. Pathogenic bacteria were cultured in 28 cases with two or more pathogens, including 72 strains of G-bacteria, 63 strains of G + bacteria, 44 strains of fungi and 38 strains of drug-resistant strains. 33.75% of patients with severe disability or death in hospital infection group were higher than 9.29% of those in non-infected group. Age, men, low GCS, invasive procedures, dehydration agents and hormones for a long time to prevent antibiotics, long hospital stay is a risk factor for nosocomial infections. Conclusion Patients with craniocerebral injury have a higher incidence of nosocomial infection and may increase the mortality rate. Active treatment of the primary disease, rational use of antibiotics, application of glucocorticoid and dehydrating agent should be shortened and hospital stay should be shortened.