CAJ | 학술논문

目的：分析NICU内重型颅脑外伤患者发生肺部感染的相关危险因素，为预防感染提供依据。方法回顾性分析2012年1月~2013年1月 NICU内收住的297例重型颅脑外伤患者的临床资料，统计院内肺部感染的发生率并分析发生的危险因素。并针对危险因素，临床采取防治措施。结果 NICU内重型脑外伤患者院内肺部感染发生率：19.9%(59/297例)，其中2012年7月~2013年1月患者肺部感染发生率12.8%（22/172例），与2012年1月~6月感染发生率29.7%（37/125例）相比，有明显降低( P<0.05)。肺部感染的发生受到患者年龄、昏迷程度（GCS评分）、入住时间、机械通气、气管切开、是否手术、合并基础疾病以及吸烟史的影响(P<0.05)。结论患者年龄、昏迷程度（GCS评分）、机械通气、气管切开、合并基础疾病及吸烟史是重型颅脑外伤患者发生肺部感染的危险因素，而严格的消毒隔离措施，针对发生院内肺部感染的危险因素并采取有效预防是降低院内感染发生率，提高患者治愈率的关键。
목적：분석NICU내중형로뇌외상환자발생폐부감염적상관위험인소，위예방감염제공의거。방법회고성분석2012년1월~2013년1월 NICU내수주적297례중형로뇌외상환자적림상자료，통계원내폐부감염적발생솔병분석발생적위험인소。병침대위험인소，림상채취방치조시。결과 NICU내중형뇌외상환자원내폐부감염발생솔：19.9%(59/297례)，기중2012년7월~2013년1월환자폐부감염발생솔12.8%（22/172례），여2012년1월~6월감염발생솔29.7%（37/125례）상비，유명현강저( P<0.05)。폐부감염적발생수도환자년령、혼미정도（GCS평분）、입주시간、궤계통기、기관절개、시부수술、합병기출질병이급흡연사적영향(P<0.05)。결론환자년령、혼미정도（GCS평분）、궤계통기、기관절개、합병기출질병급흡연사시중형로뇌외상환자발생폐부감염적위험인소，이엄격적소독격리조시，침대발생원내폐부감염적위험인소병채취유효예방시강저원내감염발생솔，제고환자치유솔적관건。
Objective To analyze the risk factors of pulmonary infection in severe brain injury patients in NICU, and to strengthen the clinical measures to prevent pulmonary infections. Methods The clinical data of 297 serious brain injury patients hospitalized in the Intensive Care Unit of Neurosurgery of Taixing Hospital af iliated to Yangzhou University from January 2012 to January 2013 were analyzed retrospectively. and the clinical measures of prevention were taken according to the risk factors. Results The incidence rate of nosocomial pulmonary infection in severe brain injury patients was 19.9%. Al the patients were divided into two groups ,A and B . Compared with the incidence of infection (29.7%) in first half year,the infection rate in second half , 12.8%, decreased significantly (P<0.05). The pulmonary infection occurrence was correlated with patients age, the score of Glasgow Coma Scale, mechanical ventilation, tracheotomy, length of stay in NICU, combining with underlying disease,operation treatment and Smoking history. the dif erence was al statistical y significant (P<0.05). Conclusions The advanced age,coma, mechanical ventilation, tracheotomy, long time staying in NICU, combining with underlying disease,operation treatment, and Smoking history are the risk factors associated with the nosocomial pulmonary infections in the patients with severe brain injury, the Strict disinfection and isolation in NICU is the critical countermeasure ,appropriate preventive measures should be taken to reduce the incidence of pulmonary infection and promote the rehabilitation of the patients.