目的：探讨老年高血压脑出血患者术后并发肺部感染的相关危险因素及对策。方法回顾性分析高血压脑出血并发肺部感染54例的临床资料，观察肺部感染的发生率。结果气管插管全麻术后肺部感染发生率74.24％，明显高于局麻手术组，2组比较差异有统计学意义（ P＜0.05）。大骨瓣开颅术后肺部感染发生率最高，达92％，明显高于小骨窗开颅显微组和血肿钻孔引流组的67％、36％，差异有统计学意义（ P＜0.05）。原有肺部基础疾病和长期抽烟可明显增加术后肺部感染的发生率。其中慢性阻塞性肺疾病（Chronic obstructive pulmonary disease ，COPD ）或支哮等呼吸道疾患术后感染率高达100％。结论选用气管插管全麻和大骨瓣开颅术，以及患者原有肺部基础疾病和长期抽烟史可明显增加老年高血压脑出血患者术后肺部感染的发生率和病死率。%Objective To explore the related risk factors and countermeasure of elderly hypertensive intracerebral hemor‐rhage postoperative pulmonary infection .Methods Clinical data of 54 patients who accepted surgical treatments in 81 cases of pulmonary infection of elderly patients with hypertension cerebral hemorrhage from January 2009 to November 2013 were retro‐spectively analyzed ,in order to observe the incidence of pulmonary infection .Results Endotracheal intubation anesthesia post‐operative pulmonary infection incidence was 74 .24% ,which was significantly higher than the local anesthesia surgery group . Two groups are statistically significant (P<0 .05) .Big bone flap craniotomy postoperative pulmonary infection incidence was highest ,up to 92% ,which was significantly higher than 67% of small bone window craniotomy microscopic group ,and 36%of drainage of hematoma drilling .The difference was statistically significant (P< 0 .05) .Primary lung disease and the long‐term smoking can obviously increase the incidence of postoperative pulmonary infection ,and the postoperative infection rate of COPD or asthma and other respiratory diseases was up to 100% .Conclusion Choosing the endotracheal intubation anesthesia and big bone flap craniotomy surgery ,and patients with primary lung disease and the long‐term smoking history can obviously increase the incidence of hypertension cerebral hemorrhage postoperative pulmonary infection and fatality rate .
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