摘要
目的探讨急性脑卒中患者病情严重程度对术后发生感染的影响,为降低术后感染提供参考。方法收集2009年1月-2013年12月259例行手术治疗的急性脑卒中患者临床资料,回顾性分析病情严重程度对术后感染发生的影响,并对患者术后医院感染率、感染病原菌分布等资料进行统计分析,数据采用SPSS17.0软件进行统计处理。结果 259例行手术治疗的急性脑卒中患者术后发生感染49例,感染率为18.92%;主要感染部位为呼吸道及泌尿道,分别占46.94%及22.45%;49例术后感染患者中34例送检痰液、尿液、局部分泌物等标本进行病原菌培养,21例患者标本检出阳性,阳性率为61.77%;共检出病原菌25株,其中革兰阴性菌19株占76.00%,革兰阳性菌6株占24.00%;术前不同神经功能缺损评分(NIHSS)及昏迷程度(GCS)评分、脑损伤体积患者术后感染率比较差异有统计学意义(P<0.05);术后感染与未感染患者术前NIHSS及GCS评分、脑损伤体积比较差异有统计学意义(P<0.05)。结论急性脑卒中患者病情严重程度与术后感染发生关系密切,NIHSS评分越高、GCS评分越低、脑损伤体积越大时医院感染率越高。
OBJECTIVE To study the influence of the severity of acute cerebral apoplexy on postoperative infec‐tions ,so as to provide a reference for reducing postoperative infections .METHODS The clinical data of 259 cases of patients with acute cerebral apoplexy were collected ,and the influence of the severity degree of the disease on postoperative infections was retrospectively analyzed .Infection rate and distribution of pathogenic bacteria was statistically analyzed .All data were analyzed by SPSS 17 .0 software .RESULTS Totally 49 cases in the 259 pa‐tients with acute cerebral apoplexy after surgery were infected ,and the infection rate was 18 .92% .Respiratory tract and urinary tract were the major sites being infected ,accounting for 46 .94% and 22 .45% respectively .To‐tally 34 cases of patients had their samples of sputum ,urine and partial secretions been detected and 21 cases were found to have positive bacteria and the positive rate was 61 .77% .A total of 25 strains of pathogenic bacteria were detected ,including 19 strains of gram‐negative bacteria ,accounting for 76 .00% and 6 strains of gram‐positive bacteria ,holding 24 .00% .The comparison of preoperative NIHSS ,GCS and volume of cerebral injury was signif‐icant （P〈0 .05） and comparison of preoperative GCS scores ,volume of postoperative infections in patients with brain injury and postoperative infection had significant difference （P〈0 .05） .CONCLUSION The severity of acute cerebral apoplexy is closely related to postoperative infections .High NIHSS score ,low GCS score ,and large vol‐ume of brain damage are all related to high hospital infection rate .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第19期4475-4477,共3页
Chinese Journal of Nosocomiology
基金
河南省教育厅科学技术研究基金资助项目(12B180005)
