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目的探讨重症监护室(ICU)脑瘤术后发生肺部感染相关危险因素,为预防感染提供依据。方法分析作者医院ICU病房48例脑瘤术后发生肺部感染的临床资料,统计与肺部感染发生相关的因素,并分析感染者痰培养结果。结果年龄≥50岁、有吸烟史、格拉斯哥昏迷评分(glosgow coma score,GCS)评分<7分、卧床时间≥10 d、术前合并有慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)、术前有其它基础疾病(糖尿病、肝病、肾病等)、气管切开时间≥5 d、吸痰次数≥8次/d、有侵入性操作(气管插管、机械通气、留置胃管),感染率显著升高(均P<0.05)。感染病原菌主要是革兰阴性菌(65.5%),常见细菌为铜绿假单孢菌(18.2%)和金黄色葡萄球菌(15.5%)。结论 ICU脑瘤术后肺部感染是由多种因素参与的,且发生率较高,应引起高度重视,及时治疗或去除诱发肺部感染的相关因素,提高患者生存质量。
Objective To investigate the risk factors associated with pulmonary infection after intensive care unit (ICU) brain tumor surgery in order to provide a basis for prevention of infection. Methods The clinical data of 48 cases with pulmonary infection in the ICU ward of the author hospital were analyzed. The factors related to the occurrence of pulmonary infection were analyzed. The sputum culture results were analyzed. Results A mean age of 50 years or older was with a history of smoking. Glasgow coma score (GCS) was less than 7 points and bed rest time was 10 days. Chronic obstructive pulmonary disease (COPD) Before the other underlying diseases (diabetes, liver disease, kidney disease, etc.), tracheotomy time ≥ 5 d, sputum suction times ≥ 8 times / d, with invasive procedures (endotracheal intubation, mechanical ventilation, indwelling gastric tube), infection rate Significantly increased (all P <0.05). The major pathogenic bacteria were Gram-negative bacteria (65.5%). The common bacteria were Pseudomonas aeruginosa (18.2%) and Staphylococcus aureus (15.5%). CONCLUSIONS: Pulmonary infection after ICU brain tumor operation is caused by a variety of factors, and the incidence is high. It is necessary to pay close attention to the prompt treatment or removal of the related factors of lung infection and to improve the quality of life of patients.