ICU脑外伤昏迷患者发生肺部感染的影响因素分析与护理对策

摘要

目的:探讨ICU脑外伤昏迷患者发生肺部感染的影响因素并针对性的提出护理对策.方法:选取我院ICU2014年1月～2017年5月收治的115例脑外伤昏迷患者,收集所有患者临床资料,分析发生肺部感染的相关因素,采用logistic回归方程分析并进行独立危险因素分析,针对性制定护理对策.结果:115例脑外伤昏迷患者中41例发生肺部感染,感染率为35.65％;单因素分析显示,机械通气、激素使用情况、气管切开、胃管留置、ICU住院时间、吸烟史、格拉斯哥昏迷评分(GCS)、合并基础疾病均与肺部感染的发生存在相关性(P<0.05);多因素logistic回归分析显示,机械通气、使用激素、气管切开、留置胃管、ICU住院时间≥7 d、GCS评分≤4分、合并基础疾病均是导致脑外伤昏迷患者发生肺部感染的独立危险因素(P<0.05).结论:引发脑外伤昏迷患者出现肺部感染的危险因素较多,依据危险因素针对性的制定护理对策可有效降低肺部感染发生率,值得临床推广.%Objective:To investigate the influencing factors of pulmonary infection on ICU coma patients with brain trauma and propose targeted nursing countermeasures. Methods:A total of 115 ICU coma patients with brain trauma admitted to our hospital from January 2014 to May 2017 were selected and their clinical data were collected. The targeted nursing countermeasures were proposed after the analysis of the related factors of pulmonary infection by utili-zing logistic regression equation and independent risk factors. Results:The infection rate was 35. 65％ in 41 out of 115 coma patients with brain trauma;the univariate analysis showed that mechanical ventilation,hormone use,tracheotomy,gastric tube indwelling,ICU stay,smoking history,Glasgow coma score (GCS)and combined underlying diseases were all associated with pulmonary infection(P < 0. 05). Multivariate logistic regression analysis showed that mechanical ventilation,hormone use,tracheotomy,indwelling gastric tube,ICU stay ≥7 days,GCS≤4 points,combined underlying diseases were all the independent risk factors that led to pulmonary infection in coma patients with brain trauma(P < 0. 05). Conclusion:There are numerous risk factors for pulmonary infection in coma patients with brain trauma. Targeted nursing countermeasures based on risk factors can effectively reduce the incidence of pul-monary infection and deserve clinical promotion.