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目的:探讨神经外科重症监护室医院获得性肺炎的诱发因素、病原菌分布及其耐药性,为疾病的防治提供参考。方法:回顾性分析2003～2005年我科重症监护室73例医院获得性肺炎患者的临床资料,标本均经人工气道直接从深部吸痰取样,应用VITEK2细胞鉴定系统对标本进行鉴定。结果:常见诱发因素为意识障碍、气管插管、气管切开术和机械通气治疗等;最常见病原菌为革兰阴性菌,以铜绿假单胞菌、鲍曼不动杆菌和肺炎克雷伯菌为主;药物敏感试验易出现多重高比例耐药。结论:保持呼吸道通畅,合理使用抗生素,加强全身支持治疗是防治神经外科重症监护室医院获得性肺炎的有效手段。
Objective: To investigate the predisposing factors, pathogen distribution and drug resistance of hospital acquired pneumonia in neurosurgical intensive care unit, and to provide reference for the prevention and treatment of the disease. Methods: The clinical data of 73 hospital acquired pneumonia patients from 2003 to 2005 in our intensive care unit were retrospectively analyzed. Samples were taken directly from the deep suctioning by artificial airway and identified by VITEK2 cell identification system. Results: Common inducing factors were disturbance of consciousness, endotracheal intubation, tracheostomy and mechanical ventilation. The most common pathogens were gram-negative bacteria, Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae Mainly drug susceptibility testing prone to multiple high proportion of drug resistance. Conclusion: Maintaining airway patency, rational use of antibiotics, and strengthening of systemic supportive care are effective measures to prevent and cure hospital-acquired pneumonia in neurosurgical intensive care unit.