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颅脑损伤病人行气管切开术后痰液致病菌的监测 |
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颅脑损伤病人行气管切开术后痰液致病菌的监测
摘要 目的:为了探讨气管切开术后患者下呼吸道感染、致病菌及分布情况。方法:分析医院ICU病房自2003年1月至2004年1月35例重型颅脑损伤行气管切开人工气道通气病人呼吸道分泌物细菌学检验。结果:本组35例中首次细菌学检验有23例分离出致病菌，阳性率65.7％。其中革兰氏阴性杆菌17例占73.9％。35例共行细菌学检验94例次，获得阳性结果79例次，送检阳性率达84.04％以后在拔管前每周1次共64次细菌学检验中，阴性次数8例次，占12.5％，单纯细菌感染52例次，二重感染1例次，细菌、真菌混合感染3例次，气道内致病菌种类以革兰氏阴性杆菌为主。结论:重型颅脑损伤病人气管切开术后可致下呼吸道致病菌定植，易致呼吸道感染，需采取有效措施预防和控制感染。
关键词 气管切开术 致病菌 监测
Abstract Objective：To study the infection of the upper respiratory tract of the patients after tracheotomy.Method：Analyse the bacteriological inspection of the secretion in the respiratory tract of the patients with serious cranio-cerebral injury after tracheotomy.The analyses are based on the 35 serious cases in the ICU of our hospital from January,2003 to January,2004.Result：Pathogenic bacteria have been isolated from 23 cases out of the 35 ones through the first bacteriological examination.The positive rate is 65.7%.Of the 23 cases，17 have gram-negative bacilli.That is 73.9％.94 bacteriological examinations were carried out on the 35 cases，79 of which were positive.The positive rate is 84.04％.Of the following 64 bacteriological examinations，which were carried out once a week before extubation，eight cases were negative.That is 12.04％.Fifty-two cases belong to simple bacterial infection，one case belongs to double infection and three causes belong to mixed infection caused by bacteria and fungi.The pathogenic bacteria are mainly gram-negative.Conclusion：The tracheotomy on patients with serious cranio-cerebral injury might cause the setting of pathogenic bacteria in the lower respiratory tract and thus cause respiratory infection.So measures must be taken to prevent and control infection.
Key words tracheotomy Pathogenic bacteria monitoring
在重型颅脑损伤病人抢救中往往采取气管切开术以解除呼吸困难，由于呼吸模式的改变，有关下呼吸道致病菌定植及相关性的研究已得到关注。我对医院ICU病房自2003年1月至2004年1月35例重型颅脑损伤行气管切开人工气道通气病人，在气管切开术后1[1] [2] [3] 下一页
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